静脉内石术后侧枝阻塞:一个案例报告
Akito Setoguchi1, Masayoshi Takeno1, Saburo Kusumoto1
1Department of Cardiovascular Medicine, Nagasaki Harbor Medical Center, Nagasaki, JPN.
Cureus
|September 15, 2025
概括
血管内 (IVL) 可以破裂冠状动脉化,但很少会导致侧枝 (SB) 阻塞. 这一案例凸显了在高风险病变中进行手术前评估和保护电线的重要性,以防止这种并发症.
科学领域:
- 干预心脏病学 干预心脏病学
- 心血管成像 - 心血管成像
- 医疗器械技术 医疗器械技术
背景情况:
- 静脉内石 (IVL) 用于治疗复杂的冠状动脉结石化.
- 侧枝 (SB) 堵塞是IVL之后的罕见但严重的并发症.
- 光学连贯性断层扫描 (OCT) 对于评估化和手术结果至关重要.
研究的目的:
- 在IVL之后报告一个罕见的SB闭塞病例.
- 研究与IVL相关的SB闭塞的机制.
- 在IVL期间强调SB封闭的预防策略.
主要方法:
- 一份病例报告显示,一名80岁的男性患有严重的LAD化,正在接受IVL治疗.
- 程序前评估即时无波比率,分流储备和OCT.
- 接下来是静脉注射,然后是支架植入和扩张后.
- 治疗急性SB闭塞,使用线路交叉和吻气球膨胀.
主要成果:
- IVL成功地破裂了严重的化,增加了光线面积.
- D3 SB的急性阻塞发生在支架后,D1的流量减少.
- 经过测试,OCT发现骨折的化突出到SB骨,导致闭塞.
- 亲吻气球通货膨胀成功地恢复了D3中的TIMI 3流量.
结论:
- 与IVL相关的SB阻塞很少见,但可能由于化突起而发生.
- 仔细的程序前评估对于识别高风险病变至关重要.
- 应考虑在高风险的分叉病变中使用保护电线,以防止SB封闭.
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