葛雷:CTOCC CTO-PCI流程图——正向、逆向、ADR 如何选择治疗策略?(一)

学习CTOCC CTO-PCI流程图的你

一定有此疑惑:

如何选择正向、逆向、IVUS指引及ADR技术?

别着急,葛雷教授带来动态幻灯版讲座:

《CTOCC CTO-PCI流程图精讲》

为您解答上述疑问

PS:本篇为第一部分

第二部分将于下周发布,敬请期待哦~

转自:CTOCC微信群


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Case 1: Male 66 yrs, first attempt failed in local hospital

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7F EBU 3.5, 6F SAL 1.0

 • Stump 

 • Lesion length > 20 mm  

 • Absence calcification 

 • Promising landing zone 

 • Tortuosity epicardial CC

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 XT R                KDL Parallel wiring UB3

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Corsair Not Crossboss!

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Stingray LP

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Stick with GAIA Third

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Final Results

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既往逆向技术尝试失败,再次逆向成功率不高者

Case 2:Male,79 yrs old, Stable angina

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 March2015

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5 hours later……

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July2018

• No stump 

 • Lesion length > 20mm 

 • Severe tortuosity CC (Retro attempt failed) 

 • Diffuse lesion in target vessel

海昌俱乐部演示病例  115930

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海昌俱乐部演示病例  115930

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Step up: UB3 - GAIA Third - Conquest Pro

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海昌俱乐部演示病例  115930

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In side branch of LAD

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海昌俱乐部演示病例  115930

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KDL: GAIA Third

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海昌俱乐部演示病例  115930

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Step down: GAIA Third – UB3

海昌俱乐部演示病例  115930

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Stingray balloon

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海昌俱乐部演示病例  115930

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Post blood drawn

海昌俱乐部演示病例  115930

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Stick and swap to GAIA Third

海昌俱乐部演示病例  115930

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海昌俱乐部演示病例  115930

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Final Results

海昌俱乐部演示病例  115930

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当逆向技术困难时,如解剖条件许可,应优选ADR

Case 3:男, 58岁,LVEF 45%

 • Ipsilateral CC without an attacking length 

 • Ipsilateral with unfavorable attacking angle 

 • Severe tortuous and tiny epicardial CC 

 • Distal end bifurcation 

 • Promising landing zone

CTOCC JS 2018手术演示病例

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135 cm Corsair + UB3

CTOCC JS 2018手术演示病例

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Stingray balloon with optimal position

CTOCC JS 2018手术演示病例

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Double blind stick with stingray wire

CTOCC JS 2018手术演示病例

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CTOCC JS 2018手术演示病例

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Swap for Pilot 200

CTOCC JS 2018手术演示病例

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Swap for GAIA third

CTOCC JS 2018手术演示病例

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Final Result

CTOCC JS 2018手术演示病例

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逆向技术无条件(无可利用侧枝血管)

Case 4:Male, 70 yrs, first attempt failed in local hospital

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Index procedure: 2018-11-20

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No Promising CC

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KDL + UB3, GAIA Second

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Stingray LP + GAIA Third

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Final Results

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Case 5: Male, 58 yrs old, first attempt failed in 

 local hospital

Delta Health Live Case Demonstration

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Delta Health Live Case Demonstration

Delta Health Live Case Demonstration

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Retro: Corsair + Suoh 03

Delta Health Live Case Demonstration

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Retro: Corsair + Suoh 03

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Delta Health Live Case Demonstration

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ADR: Stingray LP + GAIA Third

Delta Health Live Case Demonstration

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ADR: Stingray LP + GAIA Third

Delta Health Live Case Demonstration

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Final Results

Delta Health Live Case Demonstration

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Case 6: Male 63 yrs, first attempt failed in August

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 • Severe ipsilateral CC 

 • Severe tortuous epicardial CC 

 • Promising landing zone

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KDL+UB 3, GAIA Third, CP 12

Corsair +CP 12

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Stingray LP with Optimal position

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Stingray LP + GAIA Third, failed

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Stingray wire

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Final Results

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