cto介入治療中的常見問題-資料下載頁
2024-09-29 21:47本頁面
【導(dǎo)讀】常見，占PCI的10-15%；最后一個(gè)沒有攻克的堡壘，成功率50-80%；30多年來，經(jīng)驗(yàn)的積累、器材的改進(jìn)、技術(shù)的進(jìn)步，僅使成功率輕微提高；近10年日本醫(yī)生總結(jié)的導(dǎo)絲通過技術(shù)使成功率進(jìn)了一。我國CTO介入治療技術(shù)正已較快的速度普及和提高。對(duì)影像學(xué)資料收集不夠準(zhǔn)確。缺乏周密手術(shù)計(jì)劃。不重視對(duì)側(cè)造影的重要性。不會(huì)應(yīng)用平行導(dǎo)絲（雙導(dǎo)絲）技術(shù)。重視“手感”、輕視“方向”。對(duì)進(jìn)入假腔缺乏判斷。術(shù)中沒有保持足夠的警覺。目前CTO病變介入治療已趨向成熟，對(duì)不同情況的處。針對(duì)各種特殊情況采取相應(yīng)的特殊技術(shù)進(jìn)行處理非常。有針對(duì)性、非常有效；雖然我們不應(yīng)停止探索，但在系統(tǒng)學(xué)習(xí)CTO介入治療。錯(cuò)誤的情報(bào)會(huì)導(dǎo)致錯(cuò)誤的結(jié)果；應(yīng)詳細(xì)閱讀冠脈造影片，從中捕獲有價(jià)值的信息，不。放過任何微小信息；CTO高手一定是讀片高手，讀片能力不是與生俱來；沒有計(jì)劃、計(jì)劃不周全的CTO介入猶如沒有作戰(zhàn)計(jì)劃。雙側(cè)同時(shí)造影可進(jìn)一步了解病變的解剖特點(diǎn)。在良好的CTO介入技術(shù)的基礎(chǔ)上，如要進(jìn)一步突破，
【正文】 aspiration from micro catheter at the wedge position close to perforation site How to manage perforation ? Dissection of a collateral pathway ? Perforation of a collateral channel hematoma perforate into a ventricle pericardial effusion/cardiac temponade ? Donor artery ischemia cause by deep engage GC proximal vessel disease dissection thrombosis Complications associate with retrograde approach ?Check the position of GC amp。 keep BP monitoring ?Check ACT once a hour ?Frequent flush the GC ?Stent the borderline lesions in the proximal segment of donor artery How to prevent acute obstruction in the donor vessels Donor vessel obstruction may lead to critical condition ? Myocardial Ischemia collateral branch damage spasm ? Aortoiliac aortic root dissection perforation of the sinus peripheral hematoma bleeding ? Device guide wire fracture with entrapment balloon fracture ? Others CIN/immoderate irradiation/ stroke Other plication did not involve in this section 謝謝大家！
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