Application of retrograde intervention in chronic total occlusion with calcification
10.3760/cma.j.issn.1008-6706.2013.21.033
- VernacularTitle:逆向介入治疗技术在冠状动脉慢性完全闭塞合并钙化病变中的应用
- Author:
Yihao ZHUANG
;
Haibo CHEN
;
Junfen YANG
;
Jiyan CHEN
- Publication Type:Journal Article
- Keywords:
Coronary artery disease;
Calcification lesion;
Retrograde wire;
Microcatheter;
Drug eluting stent
- From:
Chinese Journal of Primary Medicine and Pharmacy
2013;20(21):3274-3276
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the efficacy and safety of retrograde wire in chronic total occlusion with calcification.Methods 4 patients with chronic total occlusion with calcification were selected.3 RCA and 1 LAD as CTO target vessel.Side branches proximal to the occlusion waspresent in all patients,2 of 4 with extreme tortuosity,1 of 4 with ostial occlusion in LAD.At the support of 150cm Finecross microcatheter,all patients were treated with the retrograde technique,with 3 of 4 as primary strategy,1 of 4 as immediately after antegrade failure.Results Retrograde wire crossed the collaterals and successfully delivered distal to the occlusion in all patients.Epicardial collateral from LCX to RCA was accessed in 1 patient,and septal in 3 of 4 patients.Reverse CART technique was applied in 2 of 4 patients,and subsequent exteriorization of the retrograde wire via the antegrade guide was completed.Kissing of antegrade and retrograde microcatheters inside antegrade guide was completed and antegrade wire crossed the CTO lesion via retrograde microcatheter in 1 patient.Both retrograde and antegrade wires could not cross the CTO lesion in 1 patient with extreme tortuosity and severe calcification,and the RCA CTO lesion was not opened in this patient.Overall successful rate was 75％.Drug eluting stents were implanted in 3 successfully recanalized vessels.All patients had no complications during procedure and subsequent hospitalization.Conclusion The retrograde approach was used with high degree of success and safety in chronic total occlusion with calcification.
