Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan, Republic of China.
Catheter Cardiovasc Interv. 2011 Aug 1;78(2):237-43. doi: 10.1002/ccd.23033. Epub 2011 Jul 15.
Coronary perforation is a rare, but life-threatening, complication that can develop during a percutaneous coronary intervention (PCI). Prompt nonsurgical treatment such as covered stent deployment can potentially arrest progression of the condition; however, other lethal complications such as acute stent thrombosis or side branch occlusion can occur. This report describes a case of perforation of the left main coronary artery that was successfully managed via stenting; however, acute stent thrombosis and side branch occlusion subsequently occurred under extracorporeal membrane oxygenation support. Means of avoiding this tragic outcome involve the routine use of intravascular ultrasound in patients undergoing PCI of the left main coronary artery, being respectful of circumferential calcification, and keeping the procedure as simple as possible.
冠状动脉穿孔是一种罕见但危及生命的并发症，可在经皮冠状动脉介入治疗（PCI）过程中发生。及时的非手术治疗，如覆盖支架的部署，可能会阻止病情的进展；然而，其他致命的并发症，如急性支架血栓形成或侧支闭塞，也可能发生。本报告描述了一例左主干冠状动脉穿孔的病例，该病例通过支架治疗成功得到了控制；然而，在体外膜氧合支持下，随后发生了急性支架血栓形成和侧支闭塞。避免这种悲惨结果的方法包括在接受左主干冠状动脉 PCI 的患者中常规使用血管内超声、尊重环形钙化，并使手术尽可能简单。
