各種deviceの通過が不可能であった慢性透析患者の高度石灰化病変に対しConquest ProTMを繰り返し通過させることによりPCI可能であった1例

Usefulness of Passing Repeatedly a Conquest ProTM Guidewire for Severe Calcified Lesions of Patients with Hemodialysis,and in whom other devices can't be passed: A case report

要旨　患者は腎不全で血液透析中の66歳，男性．他院で冠動脈造影上左前下行枝(LAD)seg.7-90%，seg.8-90%の病変がありLADにPCI施行．seg.8の病変はバルーン通過せずseg.7に対しCypherステントを留置し終了．その後も胸痛発作ありseg.8のPCI目的に紹介．Guidewireは通過したがバルーンやTornusは不通過．Rota-wireで直接病変通過を試みたが不可能であった．そのためConquest Proで何回も病変を往復させた後rota-wire extra-supportで病変を通過させrotablator施行後Cypherステントを留置し終了した．その後，胸部症状消失．本例のように各種deviceの通過が不可能な場合，Conquest Proのような硬いguidewireを何回も通過させることにより，rota-wire通過のための内腔を拡大させることは有用な方法である．

　We tried to perform PCI to a calcified lesion of LAD for a 66-year-old-man with hemodialysis. We succeeded in passing a guidewire to the lesion, but we failed to pass the balloon catheter or Tornus. We also couldn't pass the rota-wire directly. After we passed a Conquest Pro guidewire to the lesion repeatedly, we were able to pass the rota-wire extra-support to the lesion directly. Finally we succeeded in utilizing a rotablator and implanting a Cypher stent. It is useful for a severe lesion through which cannot be passed by any other devices can't be passed to dilate the lesion by passing a stiff guidewire like Conquest Pro repeatedly.