双腔微导管辅助反转导丝处理左前降支极度成角分叉病变1例Double-lumen microcatheter assisted reversed guidewire treatment of anterior descending artery with extremely angulated bifurcations:a case report
张晓江,马彦卓,汝磊生
摘要(Abstract):
冠状动脉分叉病变是经皮冠状动脉介入治疗的难点之一。如何安全、高效地操作导丝进入边支,特别是合并极度成角的分叉病变,是对操作者极大的挑战。2008年反转导丝技术的提出以及此后联合双腔微导管的操作改进,在一定程度上解决了这个问题。但因病例数限制,国内各中心对此法的相关实践及病例报道较少,经验不足。本文报道1例冠状动脉左前降支慢性完全闭塞病变,伴对角支严重狭窄及极度成角,在双腔微导管辅助下反转导丝进入对角支中段内膜下,平行导丝技术返回真腔,辅以血管内超声,明确血管真腔及分叉结构、斑块构成,以对角支为主支,成功行双支架置入术。以此探讨安全高效的分叉病变反转导丝技术,分析其术前准备、启动时机、术中操作技巧、并发症预防及处理等,为临床处理此类病变提供一定的参考。
关键词(KeyWords): 冠状动脉分叉病变;反转导丝技术;双腔微导管;经皮冠状动脉介入治疗
基金项目(Foundation): 河北省医学科学研究重点课题(20130001)
作者(Author): 张晓江,马彦卓,汝磊生
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