三维CT血管造影与冠状动脉造影图像实时融合技术在冠状动脉慢性闭塞病变介入治疗中的应用:1例报道

本文回顾了我科应用三维冠脉CT血管造影(CTA)与冠状动脉造影(CAG)图像实时融合技术指导右冠状动脉慢性闭塞病变介入治疗的患者1例。该患者因"不稳定型心绞痛"入院,CAG示:前降支中段狭窄95%、前降支远端70%、回旋支近中段50%~90%,右冠近段弥漫狭窄最重85%,右冠中段闭塞。患者冠脉CTA明确右冠脉慢性闭塞病变特征,并预测慢性闭塞病变开通难易程度。同时,我们采用三维CTA与CAG图像融合技术,实时指导慢性闭塞开通,并且帮助明确球囊及支架的位置。同时运用微导管、对侧造影验证三维CTA与CAG图像融合指导的效果。

Real-time fusion of 3D-CT angiography and coronary angiography technique guides the interventional treatment of coronary artery chronic occlusion:one case report

This paper reviewed 1 case of chronic total occlusion of right coronay artery(RCA) undergoing the interventional treatment guided by real-time fusion technique of 3D-computed tomographic angiography(CTA) and coronary angiography(CAG) in our department. The patient was admitted to the hospital due to unstable angina pectoris. CAG showed that 95% stenosis in the middle part of the anterior descending branch,70% stenosis in the distal part of the anterior descending branch, 50%-90% stenosis in the pro-ximal middle segment of the circumflex branch, then most seriously, 85%, diffuse stenosis of the right proximal segment of RCA, and the middle segment of RCA totally occluded. CTA findings indicated RCA chronic total occlusion and predicted the severity of opening. At the same time, real-time fusion technique of 3D-CTA and CAG was used to guide the opening of chronic occlusion, and was helpful to identifying the position of the balloon and the stent. We also used contralateral contrast and micro-catheter to verify the effect of 3D-CTA and CAG fusion.