IVUS-guided wire penetration technique in rechanneling of coronary chronic total occlusion arteries
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Abstract: The aim of this study is to probe safety and efficacy of IVUS guided wire penetration technique in rechanneling of coronary chronic total occlusion arteries.Patients with chronic total occlusion lesion while could not determine the wire progress orientation, were selected in this study.IVUS catheter were introduced to target vessel to help verifying the starting anatomy character of occluded segment and whether the guiding wire was in the true or false lumen, then guiding the progress of guiding wire.As IVUS showed that the wire was in the true lumen of the occluded artery, proper stents were choose and placed according to the diameter and length of the lesion.Success rate, operation time, X-ray time, contrastor dosage was recorded.Complications such as coronary perforation, death, acute myocardial infarction, acute heart failure and cardiac tamponade were recorded during hospitalization and 6-month follow-up.A total of 23 continue CTO lesion were enrolled in our one year study, 20 of them were successfully implanted stents, the success rate was 87%.The reason of all the 3failure cases was due to guiding wire progressing in the false lumen of subintimal and could not adjust back to the true lumen.One coronary perforation was found but without cardiac tamponade, there was no serious complication such as acute myocardial infarction, acute heart failure, death and target vessel rebuilding.IVUS guided wire penetration technique was helpful in rechanneling of difficult chronic total occlusion lesions and the procedure was safe.
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Key words:
- coronary artery disease /
- angioplasty /
- transluminal /
- percurtaneous
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