Katsanos Konstantinos, Patel Sundip, Dourado Renato, Sabharwal Tarun
Department of Interventional Radiology, Guy's and St Thomas' Hospitals, NHS Foundation Trust, London, UK.
Cardiovasc Intervent Radiol. 2009 Sep;32(5):1071-4. doi: 10.1007/s00270-009-9657-9. Epub 2009 Jul 31.
Coronary artery perforation remains one of the most fearsome complications during cardiac catheterization procedures. Although emergent bypass surgery is the preferred treatment for cases with uncontrollable perforation, endovascular vessel sealing and arrest of bleeding with a combination of balloons, covered stents, or embolic materials have also been proposed. The authors describe a case of emergent lifesaving microcoil embolization of the distal right coronary artery in a patient with uncontrollable grade III guidewire perforation resulting in cardiac tamponade. The relevant literature is reviewed and the merits and limitations of the endovascular approach are highlighted.
冠状动脉穿孔仍然是心脏导管插入术过程中最可怕的并发症之一。尽管急诊搭桥手术是治疗无法控制的穿孔病例的首选方法，但也有人提出采用血管内封堵以及联合使用球囊、覆膜支架或栓塞材料来止血。作者描述了一例因无法控制的Ⅲ级导丝穿孔导致心脏压塞的患者，对其右冠状动脉远端进行了紧急挽救生命的微线圈栓塞治疗。本文回顾了相关文献，并强调了血管内治疗方法的优缺点。
