经桡动脉开通慢性完全闭塞性病变

1、 男性男性,81,81岁岁 病案号：病案号：436013436013 间断心前区痛间断心前区痛5 5年，加重年，加重3 3天于天于2008-03-142008-03-14入入 院院 DIA:AMIDIA:AMI PCI:08-03-19:RCA EXCEL3.0/24,3.5/18PCI:08-03-19:RCA EXCEL3.0/24,3.5/18 08-03-2508-03-25 双侧双侧 桡动脉桡动脉 EBU3.5EBU3.5 (LCA),(LCA), AL1STAL1ST (RCA)(RCA) Miracle3,PT2 MS BMW Excel 3.0/28,2.5/18Excel 3

2、.0/28,2.5/18 08-03-25 08-03-25 术毕时术毕时, ,对比剂对比剂 300 ml300 ml 男性，男性，4040岁岁 病案号：病案号：471555471555 间断心前区痛间断心前区痛5 5年于年于2009-06-182009-06-18入院入院 DIA:OMI(DIA:OMI(前壁前壁) ) RF:smokingRF:smoking PCI:2008-09-06 AMI STENT(1)PCI:2008-09-06 AMI STENT(1) 2008-10-04 STENT(2) 2008-10-04 STENT(2) 2009-06-222009-06-22 桡

3、桡-JL4 6F,-JL4 6F,股股-JR 4 6F-JR 4 6F Miracle 3,Conquest Pro, Progreat 2.4F Fielder,Progreat,OTW1.5/9() Apex push1.5/8, 2、4atm() Progreat Progreat, Conquest Pro(Progreat, Conquest Pro(逆向逆向) )，Progreat, Miracle 3(Progreat, Miracle 3(正向正向) ) 微导管中心腔照影，微导管中心腔照影，RunthroughRunthrough Partner 2.5/36,3.0/29,3

4、.5/21,Partner 2.5/36,3.0/29,3.5/21, 术毕时术毕时, ,对比剂对比剂 650ml650ml TRI (318 Patients) TFI (150 Patients) P值值 Angiographic success 82% 86%0.28 Total fluoroscopy time（min）24.49 +/- 13.18 24.07 +/- 14.12 0.36 Total procedure time（min）54.22 +/- 25.35 60.23 +/- 28.15 0.23 Contrast volume ( ml ) 395.54 +/- 18

5、0.25 406.15 +/- 173.98 0.27 In hospital MACE 12 MI (3.8%) 1 death (0.7%) and 5 MI (3.5%) 0.26 Access site vascular complications 11 (3.5%) 17 (11.3%) or= 0.001 Rathore S ，et al. A comparison of the transradial and the transfemoral approach in chronic total occlusion percutaneous coronary interventio

6、n. Catheter Cardiovasc Interv. 2009 Jun 1;73(7):883-7 男性，男性，5858岁，病案号：岁，病案号：419770419770 发作性胸骨后烧灼感半年于发作性胸骨后烧灼感半年于2007-08-2007-08- 2020入院入院 RFRF：HTHT、DMDM、吸烟、饮酒、吸烟、饮酒 ECGECG：、avF avF 导联导联T T 低平低平 DIADIA：UAPUAP、HTHT、 DMDM Case 3 2007-08-23 LCX 2007-08-23 LCX 近段近段100%100%， 病变近段迂曲明显，病变近段迂曲明显，RCALCX RCAL

7、CX 级侧枝级侧枝 EBU 3.5 EBU 3.5 6F, 6F, PTPT2 2LS/LS/P P T T2 2MSMS, , Avita Avita 2.0/15 2.0/15 mmmm 2007-08-23 2007-10-17 2007-10-17 第一次术后第一次术后 5454 天天 ATW/Miracle 3/ Fielder FC Sprinter1.5/15 mm/微导管 同时锚定边支及微导管 FB. 3.0/33 mm+3.0/18mm Why I use Pilot 150? Radiation tissue injury 2009-9 (第二次第二次PCIPCI 后后24个月个月) 08-03-2508-03-25 双侧双侧 桡动脉桡动脉 EBU3.5EBU3.5 (LCA),(LCA), AL1