Premchand Rajendra Kumar, Kumar Yerra Shiv
Director and Consultant Interventional Cardiologist, Department of Cardiology, Krishna Institute of Medical Sciences Ltd , Secunderabad, Telangana, India .
Consultant Interventional Cardiologist, Department of Cardiology, Mahaveer Hospital , Hyderabad, Telangana, India .
J Clin Diagn Res. 2017 Jan;11(1):OD06-OD07. doi: 10.7860/JCDR/2017/22241.9288. Epub 2017 Jan 1.
In cases involving stenosis or occlusions in major parts of a long vessel, natural tapering of coronary vessels may create dilemma in deciding the optimal stent size during percutaneous coronary intervention. In this regard, tapered stents have been developed recently. Herein, we present a case of 67-year-old male patient with triple vessel disease including two tandem lesions in naturally tapered Left Anterior Descending (LAD) artery. The patient received a 3.0-2.5x60 mm Sirolimus-eluting BioMime Morph stent (Meril life Sciences, Gujarat, India) in the mid-distal LAD lesion along with conventional stent implantations in other two lesions. The procedure was successful and good coronary flow was obtained after revascularization. The patient remained asymptomatic thereafter. At one year, angiographic follow-up revealed good flow and no restenosis in the LAD vessel. We are of opinion that using tapered stents with decremented diameter may offer the advantages of excellent adaptation to vessel size, vessel tapering, and good apposition in patients with long coronary lesions in tapered vessels.
在涉及长血管主要部位狭窄或闭塞的病例中，冠状动脉血管的自然变细可能会在经皮冠状动脉介入治疗期间决定最佳支架尺寸时造成困境。在这方面，锥形支架最近已被开发出来。在此，我们报告一例67岁男性患者，患有三支血管病变，包括自然变细的左前降支（LAD）动脉中的两个串联病变。该患者在LAD病变的中远端接受了一枚3.0 - 2.5x60 mm西罗莫司洗脱生物模拟形态支架（印度古吉拉特邦梅里尔生命科学公司），同时在其他两个病变处进行了传统支架植入。手术成功，血运重建后获得了良好的冠状动脉血流。此后患者一直无症状。一年时，血管造影随访显示LAD血管血流良好且无再狭窄。我们认为，使用直径递减的锥形支架可能具有以下优点：能很好地适应血管尺寸、血管变细情况，并且在锥形血管中有长冠状动脉病变的患者中能实现良好的贴壁。
