Suryanarayana Prakash, Kollampare Shubha, Movahed Mohammad Reza
Division of Cardiology, Department of Medicine, University of Arizona School of Medicine, Tucson, Arizona.
Department of Medicine, University of Arizona School of Medicine, Tucson, Arizona.
Int J Angiol. 2016 Dec;25(5):e123-e125. doi: 10.1055/s-0035-1546437. Epub 2015 Mar 23.
An 86-year-old female patient with a history of bypass surgery was admitted for recurrent dyspnea and chest pain on exertion. She underwent coronary angiography showing high-grade saphenous vein graft stenosis supplying the right coronary. During an attempt to perform percutaneous intervention, saphenous vein graft to the right coronary artery was injured by the guide catheter resulting in dissection with thrombus formation but with normal distal blood flow. The procedure was abandoned since she had normal distal flow and also due to a fear of causing extension of the dissection with further manipulation. The patient was hemodynamically stable and free of chest pain after 30 minutes of observation. The patient was later discharged home on medical treatment. After 1 month, a repeat angiography showed patent saphenous vein graft to the right coronary artery with healed dissection. This is the first case report of spontaneous recovery of iatrogenic saphenous vein graft dissection. This case is followed by the review of literature.
一位有搭桥手术史的86岁女性患者因劳力性反复呼吸困难和胸痛入院。她接受了冠状动脉造影，显示供应右冠状动脉的大隐静脉移植血管存在高度狭窄。在尝试进行经皮介入治疗时，右冠状动脉的大隐静脉移植血管被引导导管损伤，导致夹层形成并伴有血栓形成，但远端血流正常。由于她的远端血流正常，且担心进一步操作会导致夹层扩展，该手术被放弃。观察30分钟后，患者血流动力学稳定且无胸痛。患者随后接受药物治疗后出院回家。1个月后，再次血管造影显示右冠状动脉的大隐静脉移植血管通畅，夹层已愈合。这是首例医源性大隐静脉移植血管夹层自发恢复的病例报告。本文随后对相关文献进行了综述。
