Ozaki Kazuyuki, Oda Hirotaka, Suzuki Tomoyasu, Ohno Yukiko, Tsuchida Keiichi, Takahashi Kazuyoshi, Miida Tsutomu
Department of Cardiology, Niigata City General Hospital, 463-7 Shumoku, Chuo-ku, Niigata 950-1197, Japan.
J Cardiol. 2008 Feb;51(1):70-3. doi: 10.1016/j.jjcc.2007.11.001. Epub 2008 Feb 6.
A 69-year-old woman underwent percutaneous coronary intervention for a severe stenotic lesion in the bifurcation of the mid-left anterior descending artery and first diagonal branch. A single stent was implanted into the left anterior descending artery. After the stent strut was dilated by balloon inflation in the diagonal branch, dissection occurred at the ostium of the diagonal branch and resulted in side branch occlusion due to hematoma. Bailout stenting was performed in the diagonal branch, but thrombus projection occurred in the left anterior descending artery. Aspiration, balloon inflation and thrombolytic therapy were performed, but distal embolism developed. This case illustrates that thrombus projection caused by stenting in a side branch may occur as a rare complication in percutaneous coronary intervention.
一名69岁女性因左前降支中段与第一对角支分叉处的严重狭窄病变接受了经皮冠状动脉介入治疗。在左前降支植入了一枚支架。在对角支通过球囊扩张使支架支柱扩张后，对角支开口处发生夹层，并因血肿导致侧支闭塞。在对角支进行了补救性支架置入，但左前降支出现血栓突出。进行了抽吸、球囊扩张和溶栓治疗，但发生了远端栓塞。该病例表明，在经皮冠状动脉介入治疗中，侧支支架置入引起的血栓突出可能作为一种罕见的并发症出现。
