Cook Jeffrey R, Haery Cameron, Montoya Alvaro
Department of Cardiology, Illinois Masonic Medical Center, Chicago, IL 60657 USA.
J Invasive Cardiol. 2011 Aug;23(8):E183-7.
Balloon entrapment during coronary angioplasty is a rare but potentially disastrous complication of percutaneous coronary intervention (PCI), described during both angioplasty alone, as well as with stents. This report describes the case of an entrapped stent-balloon within an extremely calcified proximal left anterior descending artery (LAD) lesion, and reviews techniques and strategies that can be applied in similar situations. In this case, we suspect the open-cell design of the specific stent used, combined with the high radial force of the calcified lesion, led to a "pincer effect," and entanglement of the balloon material within the stent scaffolding. After exhaustion of all percutaneous options to retrieve the balloon, the patient was ultimately taken for urgent cardiac surgery for extraction of the balloon and vein patch of the LAD.
冠状动脉血管成形术中球囊嵌顿是经皮冠状动脉介入治疗(PCI)中一种罕见但可能灾难性的并发症,在单纯血管成形术以及使用支架时均有描述。本报告描述了一例在极度钙化的左前降支(LAD)近端病变中支架球囊嵌顿的病例,并回顾了可应用于类似情况的技术和策略。在该病例中,我们怀疑所使用的特定支架的开孔设计,加上钙化病变的高径向力,导致了“钳夹效应”,以及球囊材料在支架结构内的缠绕。在穷尽所有经皮取出球囊的方法后,患者最终接受了紧急心脏手术以取出球囊并对LAD进行静脉补片修补。