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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15mm15mm15mm
3、15mm闭塞端鼠尾样闭塞端鼠尾样闭塞端刀切样闭塞端刀切样闭塞端无分支闭塞端无分支闭塞端有分支闭塞端有分支无桥血管无桥血管水母头样桥血管水母头样桥血管不利不利锥形残端锥形残端功能性闭塞功能性闭塞解剖性闭塞解剖性闭塞无残端无残端分支后闭塞分支后闭塞分支处闭塞分支处闭塞无桥血管无桥血管桥血管形成桥血管形成有利有利The CardiovascularResearch FoundationLenox Hill Heart and VascularInstitute of New YorkThe CardiovascularResearch FoundationLenox Hill Heart and V
4、ascularInstitute of New YorkJL FL JCL VLXB GL EBU ALJR SCR JCR VRAR H-STICK LCB RCBThe CardiovascularResearch FoundationLenox Hill Heart and VascularInstitute of New YorkThe CardiovascularResearch FoundationLenox Hill Heart and VascularInstitute of New York制造商导丝商品名头端特征 形状 直径（英寸）涂层 硬度（g）Guidant Cross
5、 it 100-400 锥形 0.010 非亲水 1.6，4.8，6.8，9.5 Pilot50-200 平头 0.014 亲水 2，3，4.5BSC ChoicePT 平头 0.014 亲水 2 PT Graphix/PT2 MS 平头 0.014 亲水 3-4Cordis Shinobi/shinobi Plus 平头 0.014 亲水 2，4Terumo Crosswire NT 平头 0.014 亲水 2Asahi Miracle3-12 平头 0.014 非亲水 3，4.5，6，12 Conquest/Conquest pro 锥形 0.009 非亲水*9，12*Conquest p
6、ro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齐头闭塞The
7、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 VascularInstitute of New YorkThe CardiovascularResearch FoundationLenox Hill Heart and VascularInstitute of New YorkFighting CVD
慢性闭塞性病变介入治疗进展(-32)
