温尚煜,孙志奇,王柏颖,王满庆,刘亮,黎辉

• 1:大庆油田总医院心内科

摘要(Abstract)：

目的评价血管内超声(ⅣUS)指导前向导丝经假腔再进入真腔技术治疗冠状动脉慢性完全闭塞病变的安全性和有效性。方法纳入2006年7月至2014年4月于大庆油田总医院行ⅣUS指导前向导丝经假腔再进入真腔技术治疗慢性完全闭塞病变的患者共29例,其中男20例(69.0%),平均年龄(65.0±9.6)岁。结果29例患者共有29处病变,其中22例(75.9%)患者在ⅣUS指引下前向导丝由假腔成功进入真腔。住院期间3例(10.3%)患者诊断为PCI相关心肌梗死。术后12个月随访中发生心原性死亡1例(3.4%)、心肌梗死1例(3.4%)、靶血管血运重建2例(6.9%)。结论IVUS指导下前向导丝经假腔再进入真腔技术治疗冠状动脉慢性完全闭塞病变可提高术中成功率,降低随访中主要不良心血管事件发生率,是治疗冠状动脉慢性完全闭塞病变的一种备选方法。

关键词(KeyWords)： 血管内超声;慢性完全闭塞病变;经皮冠状动脉介入治疗

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 温尚煜,孙志奇,王柏颖,王满庆,刘亮,黎辉

参考文献(References)：

• [1]葛均波.冠状动脉慢性完全闭塞病变的介入治疗技术进展.中国介入心脏病学杂志,2008,16:181-183.
• [2]Ge JB.Current status of percutaneous coronary intervention of chronic total occlusion.J Zhejiang Univ Sci B,2012,13:589-602.
• [3]Ito S,Suzuki T,Ito T,et al.Novel technique using intravascular ultrasound-guided guidewire cross in coronary intervention for uncrossable chronic total occlusions.Circ J,2004,68:1088-1092.
• [4]赵玉英,汝磊生,彭育红,等.IVUS在前向CTO介入治疗中的应用.岭南心血管杂志增刊,2012:201.
• [5]温尚煜,王柏影,刘亮,等.经桡动脉普通导引导管7F无鞘技术治疗冠状动脉复杂病变.中国介入心脏病学杂志,2014,22:445-447.
• [6]Wilson W,Spratt JC.Advances in Procedural Techniques——Antegrade.Curr Cardiol Rev,2014,10:127-144.
• [7]Hussain F,Golian M,Tarn JW.A complex dissected chronic occlusion;targeted balloon dilatation of false lumen to access true lumen,combined localized subintimal tracking and re-entry,parallel wire,contralateral injection and a useful antegrade lumen re-entry technique.Heart Int,2012,7:e7.
• [8]Carlino M,Godino C,Latib A,et al.Subintimal tracking and reentry technique with contrast guidance;A safer approach.Catheter Cardiovasc Interv,2008,72:790-796.
• [9]Whitlow PL,Burke MN,Lombardi WL,et al.Use of a novel crossing and re-entry system in coronary chronic total occlusions that have failed standard crossing techniques:Results of the fastctos(facilitated antegrade steering technique in chronic total occlusions)trial.JACC Cardiovasc Interv,2012,5:393-401.
• [10]Tian NL,Gami SK,Ye F,et al.Angiographic and clinical comparisons of intravascular ultrasound-versus angiographyguided drug-eluting stent implantation for patients with chronic total occlusion lesions;two-year results from a randomised AIRCTO study.Euro Intervention,2015,10:1409-1417.