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目的评价国产单环网篮导丝在冠状动脉慢性完全闭塞病变(chronic total occlusion,CTO)逆向介入治疗中的有效性和安全性。方法连续入选2012年3月至2016年11月冠状动脉CTO病变逆向介入治疗中应用国产单环网篮导丝27例患者。分析患者的临床基本资料、CTO特点、网篮导丝使用情况、术中并发症发生情况及住院期间主要不良心血管事件(MACE,包括心源性死亡、再发急性心肌梗死和靶血管再次血运重建)发生情况。结果 27例患者术中均使用国产单环网篮导丝协助逆向导丝体外化,平均用时(3.5±5.4)min,其中单环网篮导丝协助微导管通过病变6例。26例患者成功置入支架,1例患者因冠状动脉严重钙化未能成功置入支架。术中未发生单环网篮导丝引起的夹层破裂、导丝断裂、圈套器不能松解、血管穿孔等严重并发症。住院期间无MACE发生。结论逆向介入治疗CTO过程中应用国产单环网篮导丝协助逆向导丝进入正向指引导管,完成逆向导丝体外化是安全、有效的,可以简化介入治疗操作步骤。
Objective To evaluate the effectiveness and safety of domestic single-loop basket guide wire in the reverse interventional therapy of chronic total occlusion (CTO) of coronary artery. Methods From March 2012 to November 2016, 27 patients with domestic single-loop basket guide wire were retrospectively treated by reverse intervention in CTO lesions of coronary artery. Analysis of the patient’s clinical basic information, CTO characteristics, the use of basket guide wire, intraoperative complications and major adverse cardiovascular events during hospitalization (MACE, including cardiac death, recurrent acute myocardial infarction and target vessel re-blood Transport reconstruction) occurred. Results All the 27 patients underwent surgery using a single-loop basket guide wire to assist the externalization of the reverse guide wire, with an average time of (3.5 ± 5.4) min. The single-loop basket guide wire assisted the microcatheter through the lesion in 6 cases. Twenty-six patients were successfully placed in the stent, and one patient was unsuccessfully placed in the stent due to severe coronary calcification. Surgery did not occur during the single ring basket wire caused by dissection rupture, guide wire rupture, snare can not be loosening, vascular complications such as serious complications. No MACE occurred during hospitalization. Conclusions In the process of reverse interventional treatment of CTO, it is safe and effective to use the domestic single-loop basket guidewire to assist the reverse guidewire into the positive guide catheter. It is safe and effective to simplify the procedure of interventional therapy.