Department of Cardiovascular Medicine, Nantan General Hospital, 25 Yagi-Ueno, Yagi-cho, Nantan city, Kyoto 629-0197, Japan.
J Cardiol. 2009 Aug;54(1):128-33. doi: 10.1016/j.jjcc.2008.10.005. Epub 2008 Dec 4.
A 64-year-old man complaining of resting angina underwent emergent coronary angiogram and significant stenosis in the mid-left anterior descending artery was discovered. Although deployment of the drug-eluting Cypher stent relieved the stenosis, the guiding catheter accidentally induced coronary dissection in the left main coronary artery (LMCA). Then, deployment of another Cypher stent at the lesion successfully managed the complication. 20 days later, although asymptomatic, extensive aortic dissection was detected from the coronary sinus of Valsalva to the femoral artery. 64-Row multidetector computed tomography demonstrated that the dissection originated from the LMCA and retrogradely expanded to the aorta. This type of dissection is a rare complication related to coronary intervention and even in such a clinical setting, asymptomatic delayed progression of retrograde aortic dissection has not previously been reported to our knowledge.
一位 64 岁男性因静息性心绞痛而就诊，紧急进行冠状动脉造影检查，发现左前降支中段有明显狭窄。尽管药物洗脱 Cypher 支架的植入缓解了狭窄，但导引导管在左主干冠状动脉（LMCA）意外引发了冠状动脉夹层。随后，在病变处植入另一枚 Cypher 支架成功处理了并发症。20 天后，尽管无症状，但从冠状动脉窦到股动脉发现广泛的主动脉夹层。64 排多层螺旋 CT 显示夹层起源于 LMCA 并逆行扩展至主动脉。这种类型的夹层是一种罕见的与冠状动脉介入相关的并发症，而且即使在这种临床情况下，无症状的逆行性主动脉夹层延迟进展也未曾见报道。
