李悦,盛力,李俭强,公永太,孙党辉,李爽,邓先柱,李为民,薛竟宜

• 1:哈尔滨医科大学附属第一医院心内科

摘要(Abstract)：

<正>冠状动脉慢性完全闭塞(chronic total occlusion,CTO)病变经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)术中,导丝通过闭塞病变而球囊不能通过是导致PCI失败的最常见原因,约占CTO病变PCI患者的10%[1]。解决方法包括更换更强支撑力的指引导管、应用子母导管技术、球囊锚定技术、Tornus导管和斑块旋磨技术等[2-7]。更换支撑力更强的指引导管需导丝重新通过闭塞病变;子母导管技术要求CTO病变近段管腔直径足够大,且有损伤冠状动脉的风险[8];边支球囊锚定技术要求CTO病变近段有直径≥2 mm的分支血管;Tornus导管能提供

关键词(KeyWords)： 慢性闭塞病变;导丝交错切割

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 李悦,盛力,李俭强,公永太,孙党辉,李爽,邓先柱,李为民,薛竟宜

参考文献(References)：

• [1]de Labriolle A,Bonello L,Roy P,et al.Comparison of Safety,Efficacy,and Outcome of Successful Versus Unsuccessful Percutaneous Coronary Intervention in“True”Chronic Total Occlusions.Am J Cardiol,2008,102:1175-1181.
• [2]Stone GW,Colombo A,Teirstein PS,et al.Percutaneous recanalization of chronically occluded coronary arteries:Procedural techniques,devices,and results.Catheter Cardiovasc Interv,2005,66:217-236.
• [3]Kirtane AJ,Stone GW.The Anchor-Tornus technique:a novel approach to“uncrossable”chronic total occlusions.Catheter Cardiovasc Interv,2007,70:554-557.
• [4]Takahashi S,Saito S,Tanaka S,et al.New method to increase a backup support of a 6 French guiding coronary catheter.Catheter Cardiovasc Interv,2004,63:452-456.
• [5]Lee NH,Suh J,Seo HS.Double anchoring balloon technique for recanalization of coronary chronic total occlusion by retrograde approach.Catheter Cardiovasc Interv,2009,73:791-794.
• [6]Tsuchikane E,Suzuki T,Asakura Y,et al.Debulking of chronic coronary total occlusions with rotational or directional atherectomy before stenting:Final results of DOCTORS study.Int J Cardiol,2008,125:397-403.
• [7]黄东,徐世坤,葛雷,等.旋磨技术治疗慢性完全闭塞合并重度钙化病变.中国介入心脏病学杂志,2014,22:131-132.
• [8]Kovacic JC,Sharma AB,Roy S,et al.GuideLiner mother-and-child guide catheter extension:a simple adjunctive tool in PCI for balloon uncrossable chronic total occlusions.J Interv Cardiol,2013,26:343-350.
• [9]Reifart N,Enayat D,Giokoglu K.A novel penetration catheter(Tornus)as bail-out device after balloon failure to recanalise long,old calcifi ed chronic occlusions.EuroIntervention,2008,3:617-621.
• [10]Hu XQ,Tang L,Zhou SH,et al.A Novel Approach to Facilitating Balloon Crossing Chronic Total Occlusions:The“Wire-Cutting”Technique.J Interven Cardiol,2012,25:297-303.