Martí Vicens, Castaño Carlos, Guiteras Pere, Vallés Ermengol, Domínguez de Rozas José M, Augé Josep M
Servicio de Cardiología, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
Rev Esp Cardiol. 2004 Oct;57(10):990-2.
Distal coronary artery perforation with an angioplasty guidewire is a rare complication that may cause cardiac tamponade, myocardial infarction, arrhythmia, and even death. The use of platelet IIb/IIIa glycoprotein receptor inhibitors increases the risk of potentially fatal complications that are difficult to manage. We report a patient on treatment with abciximab who presented coronary perforation in a distal branch of the right coronary artery caused by the coronary guidewire tip, and complicated by acute cardiac tamponade. Blood extravasation to the pericardium was stopped by releasing two metallic coils into the distal vessel, thereby avoiding the need for emergent cardiac surgery.
血管成形术导丝导致的冠状动脉远端穿孔是一种罕见的并发症，可能会引起心脏压塞、心肌梗死、心律失常，甚至死亡。使用血小板IIb/IIIa糖蛋白受体抑制剂会增加难以处理的潜在致命并发症的风险。我们报告了一名接受阿昔单抗治疗的患者，该患者因冠状动脉导丝尖端导致右冠状动脉远端分支出现冠状动脉穿孔，并并发急性心脏压塞。通过向远端血管释放两个金属线圈，心包的血液外渗得以停止，从而避免了紧急心脏手术的需要。
