LAD KTO İle Birlikte D1 Lezyonunun Tek Seansta Yönetimi: KTO ve Bifurkasyon PKG Deneyimi
Özet
Kronik total oklüzyon (KTO) girişimleri, koroner perkütan koroner girişimlerin (PKG) teknik olarak en zorlu alt gruplarından birini oluşturur. Bu zorluk, oklüzyonun başladığı proksimal kapta önemli bir yan dalın bulunduğu bifurkasyon anatomilerinde belirgin biçimde artar. Bu bölümde, sol ön inen arter (LAD) proksimalinde diyagonal dalın çıkış yaptığı noktada yer alan bir KTO olgusu sunulmaktadır. Olguda önce diyagonal dal stentlenmiş, ardından oklüde segment mikrokateter ve özelleşmiş KTO kılavuz telleri ile geçilerek ana damar stentlenmiş ve bifurkasyon iki-stent tekniğiyle tamamlanmıştır. Olgu, güncel literatür ve kılavuz önerileri ışığında tartışılmaktadır.
Chronic total occlusion (CTO) interventions represent one of the most technically demanding subsets of percutaneous coronary intervention (PCI). This difficulty increases markedly in bifurcation anatomies in which a significant side branch is present at the proximal cap where the occlusion begins. In this chapter, a CTO case located at the point where the diagonal branch arises from the proximal left anterior descending artery (LAD) is presented. In this case, the diagonal branch was first stented; the occluded segment was then crossed using a microcatheter and dedicated CTO guidewires, the main vessel was stented, and the bifurcation was completed with a two-stent technique. The case is discussed in light of the current literature and guideline recommendations.
Referanslar
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