血管内超声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  

Intravascular ultrasound-guided antegrade reentry percutaneous intervention for chronic total coronary occlusions

作　　者：温尚煜[1] 孙志奇[1] 王柏颖[1] 王满庆[1] 刘亮[1] 黎辉[1] 

机构地区：[1]大庆油田总医院心内科,黑龙江大庆163001

出　　处：《中国介入心脏病学杂志》2015年第9期504-507,共4页Chinese Journal of Interventional Cardiology

摘　　要：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。Objective To evaluate the results of intravascular ultrasound（IVUS） imaging guided antegrade reentry percutaneous intervention for chronic total occlusion（CTO） coronary lesions.Methods Between July 2006 and April 2014,IVUS-guided antegrade reentry percutaneous intervention for CTO lesions was performed in 29 de novo CTO lesions,after the antegrade guidewire entered a false lumen and pre-dilation the false lumen with a 1.5 mm balloon,IVUS catheter was advanced beyond the CTO segment in the false lumen followed by antegrade guidewire reentry technique to find the ture lumen under IVUS guidance.Results Ultrasound-guided antegrade reentry for CTO lesions was performed in 29 patients with29 de novo lesions.Among 22 cases,guidewire found the ture lumen under IVUS guidance and the success rates was 75.9%.There were 3 major adverse cardiac events recorded during hospitalization period which were diagnosed as PCI related myocardial infarction.During the 12-month follow up,there were 1 patient died of cardiovascular case,1 myocardial infarction and 2 target vessel revascularisation.Conclusions Ultrasound-guided antegrade reentry percutaneous intervention technique for CTO lesions can be a useful and safe tool for difficult CTO lesions.

关 键 词：血管内超声 慢性完全闭塞病变 经皮冠状动脉介入治疗 

分 类 号：R541.4[医药卫生—心血管疾病]