Chu Chih-Sheng, Lee Shuo-Tsan, Lee Kun-Tai, Lin Tsung-Hsien, Lin Chien-Tsai, Voon Wen-Chol, Sheu Sheng-Hsiung, Lai Wen-Ter
Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
Kaohsiung J Med Sci. 2005 Dec;21(12):566-70. doi: 10.1016/S1607-551X(09)70209-8.
Coronary stent dislodgment or embolization before deployment is a rare but challenging complication in interventional cardiology. Intracoronary embolization of the dislodged stent is associated with a high risk of coronary occlusion, due to thrombus formation and subsequent myocardial infarction. Furthermore, systemic embolization may cause severe cerebrovascular events. Nonsurgical retrieval strategies for this complication have been suggested, but bailout cardiac surgery may be indicated if percutaneous retrieval attempts fail. To our knowledge, this is the first case report of intracoronary drug-eluting stent dislodgment, and successful retrieval was accomplished by a loop snare technique. With the increasing trend of using drug-eluting stents in percutaneous coronary intervention, the likelihood of stent dislodgment or embolization may increase. It should be kept in mind, especially by coronary interventionists, how to manage this complication.
冠状动脉支架在释放前发生移位或栓塞是介入心脏病学中一种罕见但具有挑战性的并发症。移位支架的冠状动脉内栓塞由于血栓形成及随后的心肌梗死,与冠状动脉闭塞的高风险相关。此外,全身栓塞可能导致严重的脑血管事件。针对这种并发症已提出非手术取出策略,但如果经皮取出尝试失败,可能需要紧急心脏手术。据我们所知,这是冠状动脉药物洗脱支架移位的首例病例报告,并且通过圈套器技术成功取出。随着经皮冠状动脉介入治疗中使用药物洗脱支架的趋势增加,支架移位或栓塞的可能性可能会上升。尤其是冠状动脉介入医生,应牢记如何处理这种并发症。