tailieunhanh - Handbook of Advanced Interventional Cardiology - part 4

Nguồn gốc bệnh tình trạng quanh co đầu gần, kích thước, và quá trình của động mạch có khả năng ảnh hưởng đến hướng dẫn lựa chọn, tàu Compliant sao lưu gần đến mục tiêu tổn thương (không có vôi hóa) không tổn thương | 184 Practical Handbook of Advanced Interventional Cardiology Table 9-2 Evaluation of complexity prior to interventions6 Factors affecting the ability to access the lesion Left main disease Proximal tortuosity Origin size and course of artery potentially influences guide selection backup Compliant vessel proximal to the target lesion no calcification Non-critical lesions proximal to the target lesion Presence of branches affecting wire passage Factors affecting the ability to cross the lesion with a wire or a balloon Degree of stenosis and length of lesion Lesion morphology eccentricity thrombus presence of calcium complexity Lesion characteristics that affect the outcome Characteristics associated with increased incidence of dissection Characteristics associated with increased incidence of thrombotic occlusion Lesion characteristics that affect the reconstruction of a perfect lumen Bifurcated lesions Ostial lesion Angulated lesions Small vessel Lesion or arterial characteristics associated with decreased ability to deliver a stent in the case of emergency management of complication dissection perforation acute closure slow flow etc. Diffuse disease Severe calcification stiff non-accommodating channel Marked tortuosity or angulation shear stress at the exit of the newly stented area following the straightening of the Different options in the treatment of long lesion are listed in Table 9-4. TECHNICAL TIP Long or short balloons Long balloons can dilate long lesions with one balloon placement rather than doing repeated inflations with a short balloon thus avoiding plaque shifting and giving a better smooth initial result. Dilating a Complex Lesions 185 Table 9-3 New risk assessment schema Risk factors Strongest correlates Non-chronic total occlusion Degenerated saphenous vein graft SVG Moderately strong correlates Length 10 mm Lumen irregularity Large filling defect Calcium angle 45 Eccentric Severe calcification SVG age 10 years Results Highest risk High .