王斌,韩雅玲,荆全民,徐凯,王效增,马颖艳,梁振洋,王耿,刘海伟,关绍义

• 1:沈阳军区总医院心内科全军心血管病研究所

摘要(Abstract)：

目的研究边支血管内超声(intravascular ultrasound,IVUS)指导开通冠状动脉主支无残端慢性完全闭塞病变(chronic total occlusion,CTO)的可能性和疗效。方法自2010年4月至2016年9月,沈阳军区总医院心内科对14例冠状动脉主支有CTO,闭塞处无残端但有分支的冠心病患者行边支内IVUS,在IVUS指导下对主支CTO实施经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)。结果经对角支内IVUS寻找前降支中段CTO闭塞段开口10例,比例最高,占71.4%。IVUS指导导丝穿刺CTO残端成功12例,占85.7%。穿刺CTO残端后成功通过CTO达到远端真腔9例,占64.3%。共对12例患者首先尝试应用Fielder XT导丝,1例成功穿刺CTO残端。应用高硬度CTO专用导丝成功穿刺CTO残端11例。结论边支内IVUS指导开通冠状动脉主支无残端CTO是可行的,此种情况下应首选硬度较强的CTO专用导丝而非硬度较差的锥形导丝。

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

Abstract:

Keywords:

基金项目(Foundation): 辽宁省科技攻关项目(2013225089)

作者(Author): 王斌,韩雅玲,荆全民,徐凯,王效增,马颖艳,梁振洋,王耿,刘海伟,关绍义

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