García-Blas Sergio, Mainar Luis, Sanchis Juan, Núñez Julio
Hospital Clínico Universitario de Valencia, Valencia, Spain.
Hospital Clínico Universitario de Valencia, Valencia, Spain.
Rev Port Cardiol. 2016 Oct;35(10):543.e1-5. doi: 10.1016/j.repc.2015.12.009. Epub 2016 Sep 5.
A 64-year-old woman was admitted for non-ST elevation myocardial infarction. The coronary angiogram showed a severe stenosis in the left anterior descending artery (LAD) ostium. A 3.5 mm×18 mm everolimus-eluting stent was directly deployed in the left main and proximal LAD, with significant jailing of the circumflex (Cx) ostium. A 3.25 mm×11 mm everolimus-eluting stent was therefore deployed in the Cx using the T-stenting and small protrusion technique. One year later, the patient was readmitted for non-ST elevation myocardial infarction, and the coronary angiogram showed ostial restenosis of the Cx stent. Optical coherence tomography imaging confirmed the severity of ostial restenosis. Percutaneous coronary intervention by a radial approach was performed using a sheathless guide catheter.
一名64岁女性因非ST段抬高型心肌梗死入院。冠状动脉造影显示左前降支（LAD）开口处严重狭窄。一枚3.5 mm×18 mm依维莫司洗脱支架直接植入左主干和LAD近端，回旋支（Cx）开口严重受压。因此，采用T型支架置入和小突出技术在Cx置入一枚3.25 mm×11 mm依维莫司洗脱支架。一年后，患者因非ST段抬高型心肌梗死再次入院，冠状动脉造影显示Cx支架开口处再狭窄。光学相干断层扫描成像证实了开口处再狭窄的严重程度。采用无鞘导引导管经桡动脉途径进行经皮冠状动脉介入治疗。
