Miyamoto A, Mizuno K, Hakamada N, Seguchi H, Satomura K, Isojima K, Kurita A, Nakamura H
First Department of Internal Medicine, National Defense Medical College, Saitama, Japan.
Angiology. 1991 Jan;42(1):65-8. doi: 10.1177/000331979104200112.
A coronary reperfusion catheter (CRC) is designed to preserve antegrade coronary flow when abrupt coronary closure occurs during percutaneous transluminal coronary angioplasty (PTCA). Insertion of the catheter to an occluded coronary artery for a few hours has been reported to be effective for myocardial salvage: however, it is unknown how long the catheter can be kept in place without causing extension of myocardial ischemia. The authors experienced a case in which the CRC was kept in place for twenty-four hours for anticoagulant therapy of an occluded coronary artery following failure of PTCA. This case suggests that adequate anticoagulant therapy can prolong the period during which a CRC can be kept in place if emergency coronary bypass surgery cannot be performed immediately after failure of coronary angioplasty.
冠状动脉再灌注导管（CRC）的设计目的是在经皮腔内冠状动脉成形术（PTCA）期间发生冠状动脉突然闭塞时维持冠状动脉的前向血流。据报道，将该导管插入闭塞的冠状动脉数小时对心肌挽救有效：然而，尚不清楚导管在不导致心肌缺血扩展的情况下可以在原位保留多长时间。作者遇到了一例在PTCA失败后，为闭塞冠状动脉的抗凝治疗将CRC保留原位24小时的病例。该病例表明，如果冠状动脉成形术失败后不能立即进行急诊冠状动脉搭桥手术，充分的抗凝治疗可以延长CRC在原位保留的时间。
