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经血管内超声引导非保护左主干支架置入术成功治疗医源性主动脉-冠状动脉夹层：病例报告及文献复习

Iatrogenic Aorto-Coronary Dissection Successfully Treated With IVUS Guided Unprotected Left Main Stenting: Case Report and Review of Literature.

作者信息

Murthy Avinash, Singh Arti, Tuohy Edward R

机构信息

Division of Cardiology, Bridgeport Hospital, 267 Grant Street, Bridgeport, USA.

出版信息

Cardiol Res. 2014 Apr;5(2):75-79. doi: 10.14740/cr329w. Epub 2014 May 15.

DOI:10.14740/cr329w
PMID:28392879
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5358178/
Abstract

A 52-year-old male underwent cardiac catheterization for abnormal stress test. Trans-radial coronary angiography revealed a severe proximal left anterior descending artery (LAD) lesion. LAD angioplasty was performed with two drug-eluting stents. This resulted in dissection of the proximal LAD, the circumflex artery and the left main coronary artery (LMCA) extending back into the coronary sinus. A diagnosis of type 3 coronary dissection was made. The circumflex artery and the left coronary artery were stented, and then the LMCA was stented. Repeat intravascular ultrasound showed resolution of the dissection and TIMI-3 flow was achieved in all vessels. He underwent follow-up angiography in 1 month, which revealed patent stents with resolution of the aorto-coronary dissection. We report a rare case of iatrogenic aorto-coronary dissection that was successfully treated with unprotected left main percutaneous coronary intervention strategy alone and review the pertinent literature.

摘要

一名52岁男性因运动负荷试验异常接受了心导管检查。经桡动脉冠状动脉造影显示左前降支（LAD）近端严重病变。对LAD进行了血管成形术并植入了两枚药物洗脱支架。这导致LAD近端、回旋支动脉和左冠状动脉主干（LMCA）发生夹层，并延伸至冠状窦。诊断为3型冠状动脉夹层。对回旋支动脉和左冠状动脉进行了支架植入，然后对LMCA进行了支架植入。重复血管内超声显示夹层消失，所有血管均达到TIMI-3级血流。1个月后他接受了随访血管造影，结果显示支架通畅，主动脉-冠状动脉夹层消失。我们报告了一例罕见的医源性主动脉-冠状动脉夹层病例，该病例仅通过无保护左主干经皮冠状动脉介入治疗策略成功治愈，并复习相关文献。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/545b/5358178/f07df1d4aeeb/cr-05-075-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/545b/5358178/36b4b32ffcbb/cr-05-075-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/545b/5358178/e0282323360f/cr-05-075-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/545b/5358178/3be8628ed412/cr-05-075-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/545b/5358178/b83b0414235f/cr-05-075-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/545b/5358178/b679774e3eaa/cr-05-075-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/545b/5358178/69bb4c600540/cr-05-075-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/545b/5358178/f07df1d4aeeb/cr-05-075-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/545b/5358178/36b4b32ffcbb/cr-05-075-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/545b/5358178/e0282323360f/cr-05-075-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/545b/5358178/3be8628ed412/cr-05-075-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/545b/5358178/b83b0414235f/cr-05-075-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/545b/5358178/b679774e3eaa/cr-05-075-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/545b/5358178/69bb4c600540/cr-05-075-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/545b/5358178/f07df1d4aeeb/cr-05-075-g007.jpg

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本文引用的文献

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Left main coronary artery dissection during percutaneous coronary intervention treated by stenting.经皮冠状动脉介入治疗期间左主干冠状动脉夹层采用支架置入术治疗。
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