慢性闭塞性病变介入治疗进展

1、n指冠状动脉显著的动脉粥样硬化导致血管管腔狭窄其结果导致血管完全闭塞，被冠脉造影证实正向TIMI血流为0级，即真性闭塞。n功能性闭塞指有少量造影剂穿过病变冠状动脉狭窄为99%，远端血流延迟而且不被充盈（TIMI血流1级）。n时间超过3个月的病变考虑慢性病变。nCTO病变的患者约占冠心病患者冠脉造影的30%，占全部PCI病例的20%左右。n近端高密度的纤维帽 阻塞盲端或于分叉处很难穿透nCTO病变内纤维机化和钙化 3个月的病变中更为明显n病变内大量新生通道n远端纤维帽The CardiovascularResearch FoundationLenox Hill Heart and Vascula

2、rInstitute of New YorkThe CardiovascularResearch FoundationLenox Hill Heart and VascularInstitute of New York1. 坏死脂核、胆固醇结晶及钙坏死脂核、胆固醇结晶及钙化化The CardiovascularResearch FoundationLenox Hill Heart and VascularInstitute of New York3. 3. 微血管微血管PCIPCI成功成功PCIPCI失败失败功能性闭塞功能性闭塞解剖性闭塞解剖性闭塞3 3个月个月3 3个月个月15mm15mm1

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6、uest pro头端1mm为非亲水涂层，其余部分为亲水涂层The CardiovascularResearch FoundationLenox Hill Heart and VascularInstitute of New York鼠尾状The CardiovascularResearch FoundationLenox Hill Heart and VascularInstitute of New York闭塞段扭曲The CardiovascularResearch FoundationLenox Hill Heart and VascularInstitute of New York齐头

7、闭塞The CardiovascularResearch FoundationLenox Hill Heart and VascularInstitute of New YorkThe CardiovascularResearch FoundationLenox Hill Heart and VascularInstitute of New YorkABCDEThe CardiovascularResearch FoundationLenox Hill Heart and VascularInstitute of New Yorkl平行导丝技术平行导丝技术逆向导丝、球囊导管近端远端近端远端逆向导丝、球囊导管顺行导丝The CardiovascularResearch FoundationLenox Hill Heart and VascularInstit