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经导管取出器械卡压:经皮冠状动脉介入治疗罕见并发症的处理:病例报告及文献综述

Transcatheter retrieval of device entrapment: management of a rare complication of percutaneous coronary intervention: case report and literature review.

作者信息

Fanari Zaher, Hamid Syed Ali, Hammami Sumaya, Mohammed Asim A, Hammami Muhammad Baraa, Qureshi Wasif

机构信息

Section of Cardiology, Christiana Care Health System, Newark, Delaware.

Section of Cardiology, Christiana Care Health System, Newark, Delaware.

出版信息

Cardiovasc Revasc Med. 2015 Sep;16(6):358-61. doi: 10.1016/j.carrev.2015.04.003. Epub 2015 Apr 16.

Abstract

With the continued advancement in PCI equipment and techniques, complications arising from intracoronary manipulation are encountered. Such complications are associated with major adverse outcome including death; myocardial infarction (MI) and the need for urgent coronary artery bypass surgery (CABG), and they require prompt recognition and mediation by the interventional cardiologist. We report a case of a broken stent shaft system in the setting of acute coronary syndrome and its successful retrieval using a non-compliant balloon to trap the proximal portion of the shaft within the guide ("trapping" a procedure used in coronary Chronic Total Occlusions (CTO) interventions) followed by slow withdrawal of the whole system. This was followed by successful PCI of the culprit lesion using a drug eluting stent without any residual complications.

摘要

随着经皮冠状动脉介入治疗(PCI)设备和技术的不断进步,冠状动脉内操作引发的并发症也日益凸显。这些并发症与包括死亡、心肌梗死(MI)以及紧急冠状动脉旁路移植术(CABG)需求等主要不良后果相关,需要介入心脏病专家迅速识别并处理。我们报告一例急性冠状动脉综合征患者发生支架杆系统断裂的病例,通过使用非顺应性球囊将杆的近端部分“套住”在导管内(“套住”是冠状动脉慢性完全闭塞(CTO)介入治疗中使用的一种操作),随后缓慢撤出整个系统,成功取出断裂的支架杆系统。之后,使用药物洗脱支架对罪犯病变进行了成功的PCI治疗,未出现任何残留并发症。

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