La Manna Alessio, Geraci Salvatore, Tamburino Corrado
Ospedale Ferrarotto-Alessi, Dipartimento di Cardiologia, 31 Via S.Citelli, Catania, Italy.
J Invasive Cardiol. 2011 Dec;23(12):E277-80.
Coronary artery aneurysm is a relatively uncommon disorder characterized by coronary artery dilatation with diameter that exceeds 50% of the normal adjacent segments with atherosclerosis being the most common etiology. Aneurysms can be adjacent to a stenosis in a post- or prestenotic location. Both anatomical conditions are technically challenging regarding their percutaneous treatment because of the large discrepancy in size between the stenotic and dilated segments, and require careful choice of the most appropriate technique and device. We have successfully treated a coronary stenosis complicated by a poststenotic aneurysm in a 60-year-old patient with atypical angina using a novel self-expandable coronary stent system implanted with optical coherence tomography (OCT) guidance. OCT scan after implantation showed residual stent malapposition inside the aneurysm despite postdilatation. Thanks to the ability of this stent to self-expand over time, 6-month OCT follow-up showed an optimal result in terms of stent apposition, strut coverage, and absence of in-stent restenosis.
冠状动脉瘤是一种相对罕见的疾病，其特征是冠状动脉扩张，直径超过相邻正常节段的50%，动脉粥样硬化是最常见的病因。动脉瘤可位于狭窄部位的近端或远端。由于狭窄段和扩张段之间存在较大的尺寸差异，这两种解剖情况在经皮治疗方面都具有技术挑战性，需要谨慎选择最合适的技术和器械。我们使用一种新型的自膨胀冠状动脉支架系统，并在光学相干断层扫描（OCT）引导下，成功治疗了一名60岁患有非典型心绞痛且合并狭窄后动脉瘤的冠状动脉狭窄患者。植入后OCT扫描显示，尽管进行了后扩张，但动脉瘤内仍存在支架贴壁不良。由于这种支架能够随时间自膨胀，6个月的OCT随访显示，在支架贴壁、金属丝覆盖和无支架内再狭窄方面取得了最佳效果。
