Tehnika retrogradnog pristupa kod rekanalizacije hronično okludiranih koronarnih arterija: prikaz serije slučajeva

  • Stefan Juričić University Clinical Center of Serbia, Clinic for Cardiology, Belgrade, Serbia
  • Milorad Tešić University Clinical Center of Serbia, Clinic for Cardiology, Belgrade, Serbia
  • Milan Dobrić University Clinical Center of Serbia, Clinic for Cardiology, Belgrade, Serbia
  • Srdjan Aleksandrić University Clinical Center of Serbia, Clinic for Cardiology, Belgrade, Serbia
  • Zlatko Mehmedbegović University Clinical Center of Serbia, Clinic for Cardiology, Belgrade, Serbia
  • Goran Stanković University Clinical Center of Serbia, Clinic for Cardiology, Belgrade, Serbia
  • Dejan Orlić University Clinical Center of Serbia, Clinic for Cardiology, Belgrade, Serbia
  • Branko Beleslin University Clinical Center of Serbia, Clinic for Cardiology, Belgrade, Serbia
  • Siniša Stojković University Clinical Center of Serbia, Clinic for Cardiology, Belgrade, Serbia
DOI: https://doi.org/10.2298/VSP200606124J
Ključne reči: koronarna okluzija, endovaskularne procedure, metodi, perkutana koronarna intervencija

Sažetak


Uvod. Hronične totalne okluzije (HTO) koronarnih arterija i dalje predstavljaju neke od najizazovnijih lezija na polju interventne kardiologije. S obzirom na složenost i povećani rizik koji nosi sa sobom retrogradni pristup, HTO se najčešće izvodi nakon neuspelog anterogradnog pristupa. Prikaz bolesnika. Prikazana je serija slučajeva sa opisom retrogradnog pristupa kao specijalne tehnike lečenja koronarnih arterija putem HTO. Svi slučajevi su imali neke posebne karakteristike koje su danas deo svakodnevog portofolija u svakoj sali za kateterizaciju srca. Sve tri prikazane perkutane koronarne intervencije izvršene različitim strategijama retrogradnog pristupa uz podršku rotablatora ili intravaskularnog ultrazvuka okončane su uspešnom rekanalizacijom HTO. Zaključak. U slučaju kada postoje „interventne“ kolaterale, kao i kada je anterogradni pristup veoma težak, retrogradni pristup može povećati uspešnost procedure. Retrogradni pristup zahteva dugotrajno učenje, kao i veoma iskusne operatore koji su sposobni da samostalno izvode ovakve procedure.

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Objavljeno
2022/07/13
Broj časopisa
Vol. 79 Br. 5 (2022): Vojnosanitetski pregled
Rubrika
Prikaz bolesnika