22例前向PCI失败但逆向成功CTO病例分析A clinical analysis of 22 cases anterograde PCI failed to retrograde PCI successful therapy in chronic coronary total occlusion
李林锋,洪浪,王洪,尹秋林,蔡新勇
摘要(Abstract)：
目的探讨逆向导丝技术治疗前向失败的冠状动脉慢性完全闭塞(chronic total occlusion,CTO)病变的可行性和安全性。方法选择2008年6月至2011年12月在本院住院治疗的22例冠心病患者,年龄51~68(59±7)岁,男15例,女7例。冠状动脉造影显示冠状动脉CTO,其中14例右冠状动脉CTO,8例左冠状动脉前降支CTO。常规行前向导丝技术失败后,采用逆向导丝技术行冠状动脉介入治疗,观察手术成功率、手术时间、X线曝光时间、造影剂用量、并发症和主要不良心脏事件(包括心源性死亡、心肌梗死、靶病变血运重建)。结果 20例患者行逆向导丝技术成功,成功率为90.9%,手术时间为112~226(162±35)分钟、X线曝光时间为54~98(72±20)分钟、造影剂用量为180~290(236±27)ml、无心源性死亡和其他严重并发症发生。患者随访3~36个月,2例患者再发心绞痛,复查冠状动脉造影示:1例出现支架内再狭窄,另1例为非靶血管狭窄。结论当前向导丝技术不能通过CTO时,应用逆行导丝技术是可行和安全的,可明显提高手术成功率。
关键词(KeyWords)： 冠状动脉;慢性完全闭塞;逆行导丝;介入治疗
基金项目(Foundation):
作者(Author): 李林锋,洪浪,王洪,尹秋林,蔡新勇
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