A “microcatheter anchor technique” to prevent prolapse and facilitate retrograde chronic total occlusion intervention via a retroflexed saphenous vein graft

M. Bilal Iqbal , Minh Vo , Ram Vijayaraghavan , Benjamin Faurie , Gregor Leibundgut , Mauro Carlino , Stephane Rinfret , Emmanouil S. Brilakis
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Abstract

Chronic total occlusion percutaneous coronary intervention has lower success rates in patients with prior coronary artery bypass graft surgery. Patent or occluded bypass grafts serve as conduits for retrograde recanalization, but a common cause of failure is the acute angulated graft insertion making wiring difficult, with recurrent wire and microcatheter prolapse, if not impossible. We present a case with difficult retrograde wiring and tracking around a retroflexed graft insertion site that was successfully addressed using a strategic balloon to anchor the microcatheter – the “microcatheter anchor technique (MAT)”.

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防止脱垂的 "微导管锚定技术",有助于通过逆行大隐静脉移植进行逆行慢性全闭塞介入治疗
对于曾接受过冠状动脉旁路移植手术的患者,慢性全闭塞经皮冠状动脉介入治疗的成功率较低。通畅或闭塞的搭桥移植物可作为逆行再通导管,但失败的一个常见原因是移植物急性成角插入导致布线困难,导线和微导管反复脱垂,甚至无法布线。我们介绍了一例逆行布线困难的病例,该病例在逆行弯曲的移植物插入部位周围进行了追踪,通过使用策略性球囊锚定微导管--"微导管锚定技术(MAT)",成功地解决了这一问题。
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