Lell E, Wehr G, Sechtem U
Division of Cardiology, Robert-Bosch-Hospital, Stuttgart, Germany.
Catheter Cardiovasc Interv. 1999 Jun;47(2):186-90. doi: 10.1002/(SICI)1522-726X(199906)47:2<186::AID-CCD13>3.0.CO;2-J.
One month after a successful angioplasty, one of our patients developed a new aneurysm in the right coronary artery (RCA). The aneurysm was characterized as a pseudoaneurysm by the use of intravascular ultrasound (IVUS). A stenosis that was not well seen by angiography was better depicted by IVUS. Both the pseudoaneurysm and the stenosis were successfully treated with a second angioplasty and stenting with a covered stent. Delayed development of pseudoaneurysms after dissection is an uncommon, but possible complication after angioplasty. In this case IVUS was useful for accurate characterization of the aneurysm. The use of covered stents may become a clinically useful method for treating coronary pseudoaneurysms.
在一次成功的血管成形术后一个月，我们的一位患者在右冠状动脉（RCA）出现了一个新的动脉瘤。通过血管内超声（IVUS）检查，该动脉瘤被诊断为假性动脉瘤。血管造影未清晰显示的一处狭窄在IVUS检查中得到了更好的呈现。假性动脉瘤和狭窄均通过第二次血管成形术及使用覆膜支架置入术成功得到治疗。夹层分离后假性动脉瘤的延迟发生是血管成形术后一种不常见但有可能出现的并发症。在这个病例中，IVUS有助于准确诊断动脉瘤。覆膜支架的使用可能会成为治疗冠状动脉假性动脉瘤的一种临床实用方法。
