冠状动脉内放射治疗支架内再狭窄后发生严重急性冠状动脉痉挛：一例报告

Severe acute coronary spasm following intracoronary radiation for in-stent restenosis: a case report.

作者信息

Gruberg L, Waksman R

机构信息

Cardiac Catheterization Laboratory, Washington Hospital Center, Washington, DC 20010, USA.

出版信息

Cardiovasc Radiat Med. 2001 Jul-Sep;2(3):138-42. doi: 10.1016/s1522-1865(01)00084-1.

DOI:10.1016/s1522-1865(01)00084-1

PMID:11786319

Abstract

Intracoronary radiation therapy is currently the only available treatment for the prevention of recurrence of in-stent restenosis. We report a case of severe coronary spasm after excimer laser angioplasty, balloon angioplasty, and intracoronary gamma radiation in the right coronary artery (RCA) that resulted in an acute myocardial infarction. Treatment with 600 microg of intracoronary nitroglycerin resulted in minimal improvement; therefore, diltiazem 400 microg was administered intracoronary with total resolution of the spasm, restoring normal coronary blood flow without trace of acute dissection or thrombus inside the artery.

摘要

冠状动脉内放射治疗是目前预防支架内再狭窄复发的唯一可用治疗方法。我们报告了一例在右冠状动脉（RCA）进行准分子激光血管成形术、球囊血管成形术和冠状动脉内伽马射线照射后发生严重冠状动脉痉挛的病例，该痉挛导致了急性心肌梗死。冠状动脉内给予600微克硝酸甘油治疗后改善甚微；因此，冠状动脉内给予400微克地尔硫卓，痉挛完全缓解，冠状动脉血流恢复正常，动脉内无急性夹层或血栓痕迹。