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本文报道经对侧冠(状动)脉逆行显影闭塞冠脉远段帮助经皮穿刺冠脉腔内成形术(PTCA)。对象为平均年龄55.7(36～65)岁的18(男13、女5)例慢性完全性冠脉闭塞(其远段无前向充盈)的病人。其中11例为左前降支近段闭塞、7例为右冠脉近段或中段闭塞。闭塞时间估计为7～180天,其中15例超过8周。功能性闭塞(其远段前向显影较淡或延迟)不在本研究之列。成形术前先给予10000IU肝素和1000mg乙酰水杨酸。为排除冠状动脉痉挛和改善侧枝循环的充盈,分别向闭塞冠脉和对侧冠脉内注入2mg硝异山梨醇。左右冠脉成形术均用F8或F9号Judkins或△mplatz冠脉指引导管经右股动脉进行;对侧冠脉造
This article reports the retrograde development of the contralateral coronary artery (PDA) to help percutaneous transluminal coronary angioplasty (PTCA). The subjects were 18 (13 males and 5 females) patients with a mean age of 55.7 (36-65) years with chronic complete coronary occlusion who had no forward filling in the distal segment. Among them, 11 cases had proximal occlusion of the left anterior descending artery and 7 cases had occlusion of the proximal or middle right coronary artery. The occlusion time was estimated at 7 to 180 days, of which 15 were over 8 weeks. Functional occlusion, which has a lesser or a longer forward extent in the distal segment, is not included in this study. Prior to angioplasty, 10000 IU heparin and 1000 mg acetylsalicylic acid were given. In order to rule out coronary spasm and improve collateral circulation filling, respectively, to the occluded coronary and contralateral coronary injection of 2mg of isosorbide. Left and right coronary angioplasty with F8 or F9 number Judkins or △ mplatz coronary guide catheter through the right femoral artery; contralateral coronary artery