KAKO BEZBEDNO IZVESTI REKANALIZACIJU HRONIČNE TOTALNE OKLUZIJE RETROGRADNIM PRISTUPOM
Sažetak
Hronična totalna okluzija (engl. chronic total occlusion – CTO) koronarne arterije definiše se kao totalna (100%) opstrukcija anterogradnog protoka u nativnoj koronarnoj arteriji stara više od tri meseca.
Podaci pokazuju da se od 7% do 15% CTO leči perkutanom koronarnom intervencijom i da rekanalizacija CTO i dalje predstavlja vrhunac u perkutanim koronarnim intervencijama. U literaturi su opisane tri različite tehnike za CTO rekanalizaciju: antegradna eskalacija žice, anterogradna disekciona tehnika i retrogradna disekciona tehnika. Septalne kolaterale i dalje predstavljaju najčešći izbor u velikom broju retrogradnih CTO intervencija zbog najniže stope ozbiljnih komplikacija. Perforacije septalne kolaterale uglavnom nisu praćene ozbiljnim komplikacijama i obično se spontano povlače. Sa druge strane, korišćenje epikardnih kolaterala može biti praćeno velikom stopom uspeha i malom incidencijom proceduralnih komplikacija kada procedure revaskularizacije CTO lezija izvode iskusni interventni kardiolozi.
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