Vascular healing following subintimal tracking and reentry for chronic total occlusion percutaneous coronary intervention

Jesse A. Kane , Jasleen Tiwana , William L. Lombardi , Lorenzo Azzalini
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引用次数: 0

Abstract

A 78-year-old man with angina and ischemic cardiomyopathy presented for LAD CTO PCI. After several failed techniques, the LAD was recanalized with subintimal tracking and reentry (STAR) with subsequent balloon angioplasty of the false lumen. No stent was deployed and the patient did not follow-up for 10-months for definitive PCI. On follow-up, IVUS findings suggested the presence of a new external elastic lamina in the false lumen (side-by-side to the true lumen), indicating favorable healing. PCI was performed with an excellent angiographic result. Our case highlights a mechanism of vascular healing following dissection and re-entry-based recanalization of an LAD CTO.

慢性全闭塞经皮冠状动脉介入治疗的内膜下追踪和再通后的血管愈合
一名 78 岁的男性患有心绞痛和缺血性心肌病,前来接受 LAD CTO PCI 治疗。经过数次失败后,使用内膜下追踪和再入(STAR)术对 LAD 进行了再通路,随后对假管腔进行了球囊成形术。患者没有植入支架,10 个月后没有进行明确的 PCI 随访。随访时,IVUS检查结果显示假腔(与真腔并排)出现了新的外弹力层,表明愈合良好。PCI术后血管造影效果极佳。我们的病例强调了LAD CTO剥离后血管愈合的机制,以及基于再入口的再封堵。
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