下肢动脉慢性完全闭塞病变的开通导丝选择及治疗策略

Guidewire selection and therapeutic strategy for arterial chronic total occlusion lesion of lower extremity

【摘要】治疗策略制定及器具的限制是下肢动脉慢性完全闭塞(CTO)病变治疗需面临的两大难题。以导丝通过病变为基础的治疗策略需要介入医师良好地评估病变的性质,并能根据导丝的性能选择适合特定病变的导丝。从亲水涂层导丝到头端加硬导丝,近年导丝制造工艺的革新使得导丝的选择更多样。随着对病变性质的深入了解,介入医师对于不同CTO病变的治疗策略也开始出现相应的调整。本文通过复习已发表的文献资料,综述了目前市面上的主流导丝,并对下肢动脉CTO病变的临床治疗策略提出了建议。

基金项目:

【Abstract】Therapeutic strategy-making and instrumental limits still remain 2 major problems that challenge the treatment of arterial chronic total occlusion (CTO) of lower extremity. Guidewire crossing-based strategy requires interventionalists to evaluate the nature of lesion at first,and then choose a right guidewire according to the characteristics of different wires. From hydrophilic coating guidewire to intraluminal tip-weighted guidewire, innovation of guidewire manufacturing may provide more appropriate options for specific lesions. With the advanced understanding of the nature of the lesion, interventionalists also began to adjust treatment strategy for different CTO lesions accordingly.This paper reviewed the previously published reports in the aspect, compared the advantages and disadvantages of various guidewires, and provided strategic suggestion for clinical treatment of arterial CTO lesion of lower extremity.