共查询到20条相似文献,搜索用时 15 毫秒
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目的:总结Fielder XT导丝在功能性慢性完全闭塞(CTO)病变介入治疗中的使用体会和经验。方法:回顾分析我科2011年1月~2012年10月住院使用过Fielder XT导丝行介入治疗的CTO病变患者的影像资料。根据CTO病变的影像特点将患者分为绝对性CTO病变组和功能性CTO病变组,分别统计上述两组的CTO病变经皮冠状动脉介入治疗(PCI)成功率,统计两组的Fielder XT导丝的CTO病变通过率,并进行比较分析。结果:功能性CTO病变组和绝对性CTO病变组CTO病变的成功率分别为89%、60%(40/45、22/37,P0.01);两组Fielder XT导丝的通过率分别为:71%、24%(32/45、9/37,P0.01)。结论:Fielder XT在功能性CTO病变中有较高的导丝通过率。 相似文献
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Lorenzo Azzalini Barry Uretsky Emmanouil S. Brilakis Antonio Colombo Mauro Carlino 《Catheterization and cardiovascular interventions》2019,93(1):E24-E29
The intraplaque injection of contrast media in the recanalization of coronary chronic total occlusions (CTO) has witnessed a dynamic journey since its initial formulation. Contrast‐guided subintimal tracking and re‐entry (STAR) was the first contrast modulation technique for CTO percutaneous coronary intervention (PCI). With this technique, a forceful injection of a large volume of contrast (3–4 mL) was performed in order to achieve hydraulic recanalization of the vessel. This approach was associated with extensive vessel injury and unpredictable true lumen re‐entry, which were in turn linked to high rates of restenosis on follow‐up. In the subsequent iteration, called the “microchannel technique”, a smaller amount of contrast media (1 mL) was gently injected inside the plaque to modify its compliance by softening and recruiting loose tissue, which facilitated subsequent true‐to‐true lumen crossing with a polymer‐jacketed wire along paths of least resistance. The microchannel technique has later evolved into what is currently known as the “Carlino technique”, where a minimal volume of contrast media (<0.5 mL) is gently injected inside the occlusion, with the goal of modifying plaque compliance to facilitate guidewire and microcatheter advancement through a fibrocalcific plaque. The Carlino technique is now widely utilized to allow negotiation of difficult‐to‐cross occlusions, particularly by the “hybrid operators”, with high success rates and low incidence of complications. The purpose of this article is to provide a historical perspective on the use of contrast modulation in CTO PCI, its pathophysiological basis, as well as technical recommendations on how and when to perform these maneuvers. 相似文献
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目的:通过冠状动脉慢性闭塞病变(CTO)患者冠脉介入治疗(PCI)经验总结探讨开通CTO对于患者临床症状、左室功能、存活率和生活质量的影响。方法: 选择于心内科病房住院接受冠脉造影、其中至少1支冠脉主支血管为CTO并接受PCI的患者,根据PCI手术是否成功分为成功组和失败组。应用正向导丝技术处理病变。出院后1年对患者进行随访。评价的终点事件包括死亡、心肌梗死、中风、再次PCI治疗和冠状动脉旁路移植术(CABG)。对各项数据进行统计学分析。结果: 434名入选患者,CTO介入治疗成功316名,失败118名。PCI失败组患者既往接受PCI手术(P<0.01)或CABG术(P<0.01)显著高于PCI成功组,高龄和吸烟比例也显著高于PCI成功组。两组患者在高血压病、高血脂、陈旧心梗及糖尿病等病史和心功能方面没有显著差别。PCI失败组两支CTO病变以及多支血管病变比率均显著高于PCI成功组患者(均P<0.01)。术后1年两组患者在死亡、心梗、中风和再次PCI方面没有显著差异,失败组患者心绞痛发生率高(P<0.01),介入术后进行择期CABG手术比例高于成功组患者(P<0.01)。结论: 开通CTO可显著降低患者心绞痛和CABG手术率,而死亡、心梗、中风和再次PCI方面没有显著差异。 相似文献
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Evangelia Vemmou MD Khaldoon Alaswad MD Mitul Patel MD Ehtisham Mahmud MD James W. Choi MD Farouc A. Jaffer MD PhD Anthony H. Doing MD Phil Dattilo MD Dimitri Karmpaliotis MD PhD Oleg Krestyaninov MD Dmitrii Khelimskii MD Ilias Nikolakopoulos MD Judit Karacsonyi MD PhD Iosif Xenogiannis MD PhD Santiago Garcia MD M. Nicholas Burke MD Nidal Abi Rafeh MD Ahmed ElGuindy MD MSc Omer Goktekin MD Abir Abdo MD Bavana V. Rangan BDS MPH Shuaib Abdullah MD Emmanouil S. Brilakis MD PhD 《Journal of the American Geriatrics Society》2021,69(6):1560-1569
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Athanasios Rempakos MD Spyridon Kostantinis MD Bahadir Simsek MD Judit Karacsonyi MD PhD Michaella Alexandrou MD James W. Choi MD Paul Poommipanit MD Jaikirshan J. Khatri MD Laura Young MD Rhian Davies DO MS Stewart Benton MD Farouc A. Jaffer MD PhD Raj Chandwaney MD Lorenzo Azzalini MD PhD MSc Khaldoon Alaswad MD Brian Jefferson MD Jarrod Frizzell MD Nidal Abi-Rafeh MD Ahmed Elguindy MD Omer Goktekin MD Bavana V. Rangan BDS MPH Olga C. Mastrodemos BA Salman S. Allana MD Yader Sandoval MD Nicholas M. Burke MD Emmanouil S. Brilakis MD PhD Sevket Gorgulu MD 《Catheterization and cardiovascular interventions》2023,102(5):857-863
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A novel percutaneous coronary intervention technique for chronic total occlusion: Contralateral angiography with a single guiding catheter 下载免费PDF全文
Fuminobu Yoshimachi MD PhD Sho Torii MD PhD Takayuki Naito MD 《Catheterization and cardiovascular interventions》2016,87(6):E229-E232
We report two successful cases with a new percutaneous coronary intervention (PCI) technique to treat chronic total occlusion (CTO) by using contra‐lateral coronary angiography with a single guiding catheter (GC) safely. Firstly, a GC was inserted into the coronary artery supplying collaterals and a microcatheter was inserted into the distal side of the coronary artery. Then, the GC was retroflexed and engaged in the targeted coronary artery with CTO. While the contra‐lateral coronary artery was visualized by injection through a microcatheter, a guide wire was controlled and passed through the CTO lesion. Two sheaths insertion were necessary to perform contra‐lateral angiography in CTO PCI. This new technique makes it possible to perform safe contra‐lateral angiography with a single sheath and a single GC. It could reduce vascular access complication rates. © 2015 Wiley Periodicals, Inc. 相似文献
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Stefan P. Schumacher MD Henk Everaars MD Wijnand J. Stuijfzand MD Pepijn A. van Diemen MD Roel S. Driessen MD Michiel J. Bom MD Ruben W. de Winter MD Yvemarie B. O. Somsen MD Jennifer W. Huynh BSc Ramon B. van Loon MD PhD Peter M. van de Ven PhD Albert C. van Rossum MD PhD Maksymilian P. Opolski MD PhD Alexander Nap MD PhD Paul Knaapen MD PhD 《Catheterization and cardiovascular interventions》2021,98(5):E668-E676
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Coronary dominance and prognosis in patients with chronic total occlusion treated with percutaneous coronary intervention 下载免费PDF全文
Cathérine Gebhard MD Michael Gick MD Miroslaw Ferenc MD Barbara E. Stähli MD Fadil Ademaj MD Kambis Mashayekhi MD Heinz Joachim Buettner MD Franz‐Josef Neumann MD Aurel Toma MD 《Catheterization and cardiovascular interventions》2018,91(4):669-678
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Yvemarie B. O. Somsen MD Ruben W. de Winter MD Rocco Giunta MD Stefan P. Schumacher MD PhD Pepijn A. van Diemen MD Ruurt A. Jukema MD Wijnand J. Stuijfzand MD PhD Ibrahim Danad MD PhD Birgit I. Lissenberg – Witte PhD Niels J. Verouden MD PhD Alexander Nap MD PhD Sebastiaan A. Kleijn MD PhD Alfredo R. Galassi MD PhD José P. Henriques MD PhD Paul Knaapen MD PhD 《Catheterization and cardiovascular interventions》2023,102(5):844-856
Background
The Japanese Channel (J-Channel) score was introduced to aid in retrograde percutaneous coronary intervention (PCI) of chronic total coronary occlusions (CTOs). The predictive value of the J-Channel score has not been compared with established collateral grading systems such as the Rentrop classification and Werner grade.Aims
To investigate the predictive value of the J-Channel score, Rentrop classification and Werner grade for successful collateral channel (CC) guidewire crossing and technical CTO PCI success.Methods
A total of 600 prospectively recruited patients underwent CTO PCI. All grading systems were assessed under dual catheter injection. CC guidewire crossing was considered successful if the guidewire reached the distal segment of the CTO vessel through a retrograde approach. Technical CTO PCI success was defined as thrombolysis in myocardial infarction flow grade 3 and residual stenosis <30%.Results
Of 600 patients, 257 (43%) underwent CTO PCI through a retrograde approach. Successful CC guidewire crossing was achieved in 208 (81%) patients. The predictive value of the J-Channel score for CC guidewire crossing (area under curve 0.743) was comparable with the Rentrop classification (0.699, p = 0.094) and superior to the Werner grade (0.663, p = 0.002). Technical CTO PCI success was reported in 232 (90%) patients. The Rentrop classification exhibited a numerically higher discriminatory ability (0.676) compared to the J-Channel score (0.664) and Werner grade (0.589).Conclusions
The J-channel score might aid in strategic collateral channel selection during retrograde CTO PCI. However, the J-Channel score, Rentrop classification, and Werner grade have limited value in predicting technical CTO PCI success. 相似文献12.
Sanjog Kalra MD MSc Darshan Doshi MD MS James Sapontis MBBCh Ioanna Kosmidou MD PhD Ajay J. Kirtane MD SM Jeffrey W. Moses MD Robert F. Riley MD MS Philip Jones MS William J. Nicholson MD Adam C. Salisbury MD MSc William L. Lombardi MD James M. McCabe MD Ashish Pershad MD Taishi Hirai MD Emad Hakemi MD Juan J. Russo MD Megha Prasad MD Yousif Ahmad MD Raja Hatem MD Fotis Gkargkoulas MD John A. Spertus MD MPH R. Michael Wyman MD Farouc Jaffer MD PhD Anthony Spaedy MD Stephen Cook MD Steven P. Marso MD Karen Nugent RRT Robert Federici MD Robert W. Yeh MD MBA Martin B. Leon MD Gregg W. Stone MD Ziad A. Ali MD DPhil Manish A. Parikh MD Akiko Maehara MD David J. Cohen MD MSc Candido Batres MD J. Aaron Grantham MD Dimitri Karmpaliotis MD PhD 《Catheterization and cardiovascular interventions》2021,97(6):1162-1173
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Drug-eluting stent-supported percutaneous coronary intervention for chronic total coronary occlusion. 总被引:4,自引:0,他引:4
Angela Migliorini Guia Moschi Ruben Vergara Guido Parodi Nazario Carrabba David Antoniucci 《Catheterization and cardiovascular interventions》2006,67(3):344-348
OBJECTIVES: This study sought to determine the clinical and angiographic outcomes after drug-eluting stent (DES)-supported percutaneous coronary intervention (PCI) for chronic total coronary occlusion (CTO). BACKGROUND: There are few data about the efficacy of DES-supported PCI for CTO. METHODS: All consecutive patients who had a sirolimus-eluting stent or a paclitaxel-eluting stent implanted for CTO from December 2003 to December 2004 were analyzed. Clinical and angiographic outcomes of patients treated with DES were compared with a case-matched control group of patients treated with bare metal stents (BMS) in the 12 months before the routine use of DES. RESULTS: Successful DES-supported PCI was performed in 92 patients and 104 CTO. The case-matched control group consisted of 26 patients and 27 CTO successfully treated with BMS. There were no differences between groups in baseline clinical and angiographic characteristics. Stent length in the DES group was higher as compared with that of BMS group (51+/-28 mm vs. 40+/-19 mm, P=0.073). The 6-month major adverse cardiac event (MACE) rate was lower in the DES group as compared with that of BMS group (9.8% vs. 23%, P=0.072). The angiographic follow-rate was 80% in the DES group and 81% in the BMS group. The 6-month restenosis rate was 19% in the DES group and 45% in the BMS group (P<0.001). By multivariate analysis, it was found that in the DES group, the only predictors of restenosis were stented segment length (OR 1.031, 95% CI 1.01-1.06, P=0.009) and a target vessel reference diameter<2.5 mm (OR 6.48, 95% CI 1.51-27.83, P=0.012), while the only predictor of MACE was stent length (OR 1.04, 95% CI 1.01-1.08, P=0.006). CONCLUSIONS: DES implantation for CTO decreases the risk of mid-term restenosis and MACE. Small vessels and diffuse disease requiring the implantation of multiple stents and very long stents for full coverage of the target lesion are still associated with a relatively high risk of restenosis. 相似文献
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Luiz F. Ybarra Sonny Dandona Benoit Daneault Stphane Rinfret 《Catheterization and cardiovascular interventions》2020,96(3):609-613
Chronic total occlusion (CTO) percutaneous coronary intervention (PCI) is a technically challenging procedure. In failed cases, plaque modification strategy (also known as “investment procedure”), defined as the intentional dilation of the subintimal space through the CTO segment, can be applied. The typical dilation device used in this strategy is a regular angioplasty balloon (either semi‐ or noncompliant). Performing this technique with a drug‐coated balloon (DCB) may facilitate a staged procedure by promoting a better vessel healing. Herein, we present three cases of failed CTO PCI, managed with DCB plaque modification, and their follow‐up staged procedure. 相似文献
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