Ngo Christian, Christopoulos George, Brilakis Emmanouil S
VA North Texas Health Care System, The University of Texas Southwestern Medical Center at Dallas, Division of Cardiology (111A), 4500 S. Lancaster Rd, Dallas, TX 75216 USA.
J Invasive Cardiol. 2016 Jan;28(1):E11-2.
Coronary artery perforation is a highly feared complication of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) and can lead to pericardial effusion, tamponade, and, rarely, emergent cardiac surgery. Perforation of epicardial collaterals during retrograde CTO-PCI may be particularly challenging to treat, as embolization from both sides of the perforation may be required to control the bleeding. However, conservative measures can occasionally be effective. We present a case of epicardial collateral vessel perforation that was managed conservatively with anticoagulation reversal.
冠状动脉穿孔是慢性完全闭塞（CTO）经皮冠状动脉介入治疗（PCI）中令人高度恐惧的并发症，可导致心包积液、心脏压塞，且很少需要进行急诊心脏手术。逆行CTO-PCI期间的心外膜侧支血管穿孔可能特别难以治疗，因为可能需要从穿孔两侧进行栓塞以控制出血。然而，保守措施偶尔也可能有效。我们报告一例心外膜侧支血管穿孔病例，通过逆转抗凝进行保守治疗。
