在皮肤冠状动脉干预过程中进行支架骨折和穿孔
Safi U Khan1, Hassaan B Arshad1, Neal S Kleiman1
1Section of Interventional Cardiology, Houston Methodist DeBakey Heart and Vascular Center, Houston Methodist Hospital, Houston, Texas, USA.
JACC. Case reports
|August 22, 2025
概括
通过皮肤进行冠状动脉干预 (PCI) 时的支架骨折可能会导致严重的冠状动脉穿孔. 这种罕见但严重的并发症需要及时使用覆盖式支架治疗.
科学领域:
- 心脏病学
- 干预心脏病学
- 血管医学
背景情况:
- 支架骨折是穿皮冠状动脉干预 (PCI) 的罕见并发症.
- 在PCI过程中,静脉静脉复缩 (ISR) 带来了独特的挑战.
- 在复杂的PCI过程中可能出现机械并发症,包括支架骨折.
研究的目的:
- 在PCI中呈现IV型支架骨折与冠状动脉穿孔的情况.
- 为了强调这种罕见并发症的治疗方法.
- 讨论支架骨折和冠状动脉穿孔的风险因素和治疗选择.
主要方法:
- 一个64岁的男子在右冠状动脉中出现了复发性ISR.
- 患者接受了切割气球血管整形和胸膜治疗.
- 发生了艾利斯型III穿孔的IV型支架骨折,使用覆盖式支架进行治疗.
主要成果:
- 气球扩张导致IV型支架骨折和艾利斯型III型冠状动脉穿孔.
- 长期使用气球是无效的.
- 一个覆盖式支架的成功部署封闭了穿孔.
结论:
- 这一案例强调了PCI对ISR的机械并发症的风险.
- 在冠状动脉穿孔时, 立即使用覆盖式支架进行干预至关重要.
- 干预性心脏病学家必须警罕见的并发症,如支架骨折和穿孔.
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