逆行导丝技术治疗冠脉慢性完全闭塞病变中Fielder导丝的应用

Application of Fielder guidewire in retrograde recanalization of the chronic total occlusion of coronary arteries

目的观察Fielder导丝在逆行导丝技术治疗冠脉慢性完全闭塞病变(chronical total occlusion,CTO)中应用的效果。方法 25例CTO患者闭塞病变的靶血管远端均有良好的侧支循环血管逆行供血,仔细阅读造影图像,合理选择侧支循环血管,在1.5mmOTW球囊和1.25mm的Monorail球囊的辅助下,Fielder导丝通过侧支循环血管到达靶病变远端,为完成逆行导丝技术做准备。结果 Fielder导引导丝侧支循环通过率为96%,手术成功率为88%,无一例发生房室传导阻滞、心包填塞或死亡。支架的植入术后获得了良好的即刻血管造影结果。结论冠脉慢性完全闭塞病变血管成形术中应用Fielder导引导丝可获得较好的安全性和有效性。

Objective To observe the efficacy of application of Fielder guidewire in retrograde recanalization of chronic total occlusion （CTO） of coronary arteries. Methods Twenty five patients with CTO and good collateral circulation were included. Collateral vessels were chosen according to arteriongraphy. The Fielder guidewire reached the target lesion through the collateral vessels under the assistance of the 1.5mm OTW balloon and 1.25mm Monorail balloon. Results The recanalization rate of Fielder guidewire was 96% with a success rate of 88% in the PCI procedures. No atrioventricular block,cardiac tamponade or death happened and satisfying angiographic results were obtained after PCI. Conclusion Fielder guidewire is safe and effective applying in retrograde recanalization of CTO arteries.