Haraki Tatsuo, Uemura Ryota, Masuda Shin-ichiro, Kobayashi Nobuhiko, Lee Takeshi
Department of Cardiology, Saitama Eastern Cardiovascular Hospital, Osawa 3187-1, Koshigaya, 343-0025, Saitama, Japan.
J Med Case Rep. 2016 Apr 1;10:80. doi: 10.1186/s13256-016-0874-y.
A honeycomb-like structure in the coronary artery is rarely diagnosed by intracoronary ultrasound or optical coherence tomography. Further, its structural mechanisms and response to interventional therapy remain unknown.
A 59-year-old Japanese man was referred to our hospital because of acute decompensated heart failure with rapid atrial fibrillation. After receiving anticoagulant therapy, a coronary angiogram revealed a braid-like appearance and an intracoronary ultrasound image confirmed a honeycomb-like structure in the mid left anterior descending coronary artery. We inserted two guide wires into different partitions. Although a balloon angioplasty with a scoring device could not completely fenestrate these partitions, a stent implant was able to completely compress the structure easily.
The honeycomb-like structure of the left anterior descending coronary artery in our patient was suspected to be because of recanalization of a cardiogenic embolism. This structure may have been composed of relatively hard tissues, but was easily compressed by a stent implantation.
冠状动脉中的蜂窝状结构很少通过冠状动脉内超声或光学相干断层扫描诊断出来。此外，其结构机制以及对介入治疗的反应仍不清楚。
一名59岁的日本男性因急性失代偿性心力衰竭合并快速心房颤动被转诊至我院。接受抗凝治疗后，冠状动脉造影显示出辫状外观，冠状动脉内超声图像证实左前降支冠状动脉中段存在蜂窝状结构。我们在不同的分隔区域插入了两根导丝。尽管使用刻痕装置进行球囊血管成形术不能完全打通这些分隔区域，但植入支架能够轻松地完全压缩该结构。
我们患者左前降支冠状动脉的蜂窝状结构怀疑是心源性栓塞再通所致。这种结构可能由相对坚硬的组织构成，但通过植入支架很容易被压缩。
