使用冠心内超声波增强剂来确认4型冠心穿孔
Mehmet E Demirhan1, Jose I Nunez2, Waqas Hanif3
1Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA.
JACC. Case reports
|October 25, 2025
概括
宫内超声增强剂 (UEA) 注射准确地确定了冠状动脉穿孔 (CAP) 扩张到左心室. 这种成像技术引导了保守的管理,避免了这种复杂的PCI并发症的进一步侵入性手术.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 医疗成像医学成像
背景情况:
- 穿皮冠状动脉干预 (PCI) 期间的冠状动脉穿孔 (CAP) 需要快速识别外流,以有效管理.
- 血管造影在诊断CAP的程度和位置方面可能没有结论.
研究的目的:
- 为了证明心血管超声波增强剂 (UEA) 注射在诊断CAP时的实用性,当常规血管造影是不确定的.
- 突出多式成像在区分心周血管与内腔外流的作用.
主要方法:
- 一个病例报告,一名62岁的男性患者在PCI后出现左前下降动脉穿孔.
- 使用了冠内UEA注射,随后进行心声回声扫描以可视化外流.
- 结果与传统血管学相比较.
主要成果:
- 冠内UEA注射可视化了向左心室顶部的extravasation.
- 心声学证实了艾利斯4型CAP.
- 这些发现指导了保守的管理,防止进一步的侵入性干预.
结论:
- 冠心内UEA注射对于识别CAP扩散有价值,特别是在心周或腔内空间.
- 这种技术有助于区分外流的位置,这对于管理决策至关重要.
- 多模式成像,包括冠心内UEA回声,优化了复杂的PCI病例的临床决策和患者管理.
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