METHOD FOR CORONARY CONDUCTOR REPOSITIONING IN SUBINTIMAL RECANALISATION OF CHRONIC CORONARY ARTERY OCCLUSION Russian patent published in 2024 - IPC A61M25/01 A61F2/86 

FIELD: medicine; cardiovascular surgery.

SUBSTANCE: target artery is catheterized with a first guide catheter and a donor artery is catheterised with a second guide catheter. Chronic coronary artery occlusion is recanalised through the first guide catheter by passing the antegrade coronary guide beyond the occlusion zone subintimally, the antegrade stage is terminated, antegrade conductor is left in subintimal space. Then, a retrograde stage of the operation is performed; through the second guide catheter in the donor artery, the retrograde coronary guide is passed through the largest and direct collateral vessel retrogradely beyond the occlusion zone into the subintimal space, retrograde stage is stopped. Retrograde coronary conductor is left in the subintimal space and the stage of repositioning the retrograde coronary conductor is continued. Microcatheter is inserted along the antegrade coronary conductor into the subintimal space and a stent retriever is delivered through the lumen of the microcatheter into the subintimal space, antegrade coronary conductor is removed, then a stent retriever is opened to connect antegrade and retrograde subintimal spaces and for capturing and withdrawing the retrograde coronary conductor into the first guide catheter in the target artery. Further, stenting of the area of chronic coronary artery occlusion is performed.

EFFECT: method enables reducing the length of the operation and, as a result, reducing the radiation exposure on the patient and medical personnel; reduce the risk of complications by removing the temporary stent retriever from the subintimal space after successful gripping and repositioning of the retrograde conductor; achieving final stenting of the target coronary artery taking into account the true diameter and length of the target segment involvement.

1 cl, 1 ex, 10 dwg