Taniguchi Norimasa, Mizuguchi Yukio, Takahashi Akihiko
Department of Cardiology, Sakurakai Takahashi Hospital, 5-18-1 Oikecho, Sumaku, Kobe, Hyogo 654-0026, Japan.
Department of Cardiology, Sakurakai Takahashi Hospital, 5-18-1 Oikecho, Sumaku, Kobe, Hyogo 654-0026, Japan.
Cardiovasc Revasc Med. 2015 Jan-Feb;16(1):52-4. doi: 10.1016/j.carrev.2014.05.006. Epub 2014 May 22.
A 72-year-old man underwent primary percutaneous coronary intervention for a subtotal occlusion in the mid-portion of the left anterior descending artery involving a large diagonal branch. After successful stenting with a 3.0/24 mm bare metal stent, during which, the diagonal branch was protected with a coronary guidewire, conventional retrieval of the jailed guide wire was impossible. Subsequently, several attempts at a strong retraction of the wire with the support of a balloon catheter enabled retrieval of the trapped wire. Optical coherence tomography performed after post-dilatation, revealed that the stent was elongated to the left main coronary artery, and the structure of the strut had become coarse in the proximal portion. The stent was believed to have become entangled with the balloon catheter when the guidewire was being pulled. This case suggests that retrieving the jailed guidewire with a balloon catheter carries a potential risk of entrapment in the deformed stent.
一名72岁男性因左前降支中段次全闭塞累及一大对角支而接受了直接经皮冠状动脉介入治疗。在用一枚3.0/24毫米裸金属支架成功置入支架过程中,对角支用一根冠状动脉导丝予以保护,常规方法无法取出被卡的导丝。随后,在球囊导管的支持下多次强力牵拉导丝,成功取出了被困导丝。后扩张后进行的光学相干断层扫描显示,支架延伸至左主干冠状动脉,支架近端的支柱结构变得粗糙。据信在牵拉导丝时支架与球囊导管发生了缠绕。该病例提示,用球囊导管取出被卡导丝存在被困于变形支架的潜在风险。