UNASSIGNED: The proximal occlusion of the left anterior descending artery in a 75-year-old man presented with a completely concentric calcified ring all along the segment proximal to the occlusion. The antegrade wire could not pass the calcified occlusion, and in a retrograde approach via the right posterior descending artery the retrograde wire was not able to enter the lumen from a subintimal position outside of the calcified ring. Intravascular lithoplasty in the proximal segment led to a crack in this ring to enable the same retrograde wire now to pass into the true lumen with then successful conclusion of the case. Intravascular ultrasound demonstrated the modification of the calcified ring and the passage of the wire with only a very short subintimal pathway.
UNASSIGNED: Intravascular lithoplasty is a new option to modify severely calcified vessel segments to facilitate the reverse controlled antegrade and retrograde tracking approach. In the present case, this helped to avoid a long subintimal pathway and preserved the vessel anatomy.
■一名75岁男性的左前降支的近端闭塞,在闭塞的近端段上出现完全同心的钙化环。顺行线无法通过钙化闭塞,并且在通过右后降支动脉的逆行入路中,逆行导线无法从钙化环外部的内膜下位置进入管腔。近端段的血管内碎石术导致该环破裂,使相同的逆行钢丝现在可以进入真实的管腔,然后成功完成了该病例。血管内超声显示了钙化环的修饰和仅有很短的内膜下通路的导线通道。
■血管内碎石术是一种新的选择,可以修改严重钙化的血管段,以促进反向控制的顺行和逆行追踪方法。在目前的情况下,这有助于避免长的内膜下通路并保留血管解剖结构。