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急性比伐卢定诱导的冠状动脉支架血栓形成的光学相干断层扫描评估

Optical Coherence Tomographic Evaluation of Hyperacute Bivalirudin-Induced Coronary Stent Thrombosis.

作者信息

Peñalver Jorge L, Shatila Wassim, Perin Emerson

出版信息

Tex Heart Inst J. 2017 Aug 1;44(4):266-268. doi: 10.14503/THIJ-16-6075. eCollection 2017 Aug.

DOI:10.14503/THIJ-16-6075
PMID:28878581
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5577953/
Abstract

Thrombus formation after stent deployment has been linked to the use of heparin and of antithrombotic agents, such as bivalirudin, during percutaneous coronary intervention. Fluoroscopy has been used to identify stent thrombosis, typically after patients become symptomatic. We describe our use of optical coherence tomography to diagnose and evaluate intraprocedural stent thrombosis in a 68-year-old man who was given bivalirudin just before a percutaneous coronary procedure. This imaging method enabled immediate therapeutic intervention.

摘要

支架置入术后血栓形成与经皮冠状动脉介入治疗期间使用肝素及抗血栓药物（如比伐卢定）有关。荧光透视检查已被用于识别支架血栓形成，通常是在患者出现症状之后。我们描述了我们使用光学相干断层扫描来诊断和评估一名68岁男性在经皮冠状动脉手术前刚接受比伐卢定治疗时的术中支架血栓形成情况。这种成像方法能够立即进行治疗干预。

相似文献

1
Optical Coherence Tomographic Evaluation of Hyperacute Bivalirudin-Induced Coronary Stent Thrombosis.急性比伐卢定诱导的冠状动脉支架血栓形成的光学相干断层扫描评估
Tex Heart Inst J. 2017 Aug 1;44(4):266-268. doi: 10.14503/THIJ-16-6075. eCollection 2017 Aug.
2
Prognostic value of a high on-clopidogrel treatment platelet reactivity in bivalirudin versus abciximab treated non-ST-segment elevation myocardial infarction patients. ISAR-REACT 4 (Intracoronary Stenting and Antithrombotic Regimen: Rapid Early Action for Coronary Treatment-4) platelet substudy.替格瑞洛治疗血小板高反应性对比比伐卢定和阿昔单抗治疗非 ST 段抬高型心肌梗死患者的预后价值。ISAR-REACT 4（冠状动脉支架置入术和抗血栓治疗方案：冠状动脉治疗快速早期行动-4）血小板亚研究。
J Am Coll Cardiol. 2012 Jul 31;60(5):369-77. doi: 10.1016/j.jacc.2012.02.044. Epub 2012 Jun 6.
3
Effect of bivalirudin compared with unfractionated heparin plus abciximab on infarct size and myocardial recovery after primary percutaneous coronary intervention: the horizons-AMI CMRI substudy.比伐卢定对比普通肝素联合替罗非班对直接经皮冠状动脉介入治疗后梗死面积和心肌恢复的影响：HOURS-AMI CMRI 子研究。
Catheter Cardiovasc Interv. 2012 Jun 1;79(7):1083-9. doi: 10.1002/ccd.23179. Epub 2011 Dec 7.
4
Bivalirudin in acute myocardial infarction: "primum non nocere": the eternal dilemma: balancing risks and benefits in high-risk patients.比伐卢定用于急性心肌梗死：“首要原则是不伤害”：永恒的困境——在高危患者中权衡风险与获益
JACC Cardiovasc Interv. 2010 Aug;3(8):803-5. doi: 10.1016/j.jcin.2010.07.006.
5
Optical coherence tomography-guided treatment of very late stent thrombosis caused by inaccurate stent deployment in a bifurcation.
J Cardiovasc Med (Hagerstown). 2016 Dec;17 Suppl 2:e185-e188. doi: 10.2459/JCM.0000000000000126.
6
Comparison of bivalirudin with heparin versus abciximab with heparin for primary percutaneous coronary intervention in "Real World" practice.在“真实世界”实践中，比伐卢定与肝素联用对比阿昔单抗与肝素联用用于直接经皮冠状动脉介入治疗的比较
Cardiovasc Revasc Med. 2013 Sep-Oct;14(5):289-93. doi: 10.1016/j.carrev.2013.07.006. Epub 2013 Aug 22.
7
Frequency and predictors of stent thrombosis after percutaneous coronary intervention in acute myocardial infarction.急性心肌梗死后经皮冠状动脉介入治疗后支架血栓形成的频率及预测因素。
Circulation. 2011 Apr 26;123(16):1745-56. doi: 10.1161/CIRCULATIONAHA.110.981688. Epub 2011 Apr 11.
8
A randomized two-by-two comparison of high-dose bolus tirofiban versus abciximab and unfractionated heparin versus bivalirudin during percutaneous coronary revascularization and stent placement: the tirofiban evaluation of novel dosing versus abciximab with clopidogrel and inhibition of thrombin (TENACITY) study trial.经皮冠状动脉血运重建和支架置入术中高剂量推注替罗非班与阿昔单抗和普通肝素与比伐卢定的随机两因素两水平比较：替罗非班新型给药方案与氯吡格雷联合阿昔单抗抑制血小板糖蛋白Ⅱb/Ⅲa 受体（TENACITY）研究。
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9
Impact of bivalirudin therapy in high-risk patients with acute myocardial infarction: 1-year results from the HORIZONS-AMI (Harmonizing Outcomes with RevasculariZatiON and Stents in Acute Myocardial Infarction) trial.比伐卢定治疗急性心肌梗死高危患者的影响：HORIZONS-AMI（急性心肌梗死血管重建和支架置入与优化结果）试验 1 年结果。
JACC Cardiovasc Interv. 2010 Aug;3(8):796-802. doi: 10.1016/j.jcin.2010.05.009.
10
Current incidence and clinical outcomes of bivalirudin administration among patients undergoing primary coronary intervention for stent thrombosis elevation acute myocardial infarction.在因支架内血栓形成抬高型急性心肌梗死接受直接冠状动脉介入治疗的患者中使用比伐卢定的当前发生率及临床结果。
Coron Artery Dis. 2007 Mar;18(2):141-8. doi: 10.1097/MCA.0b013e328010a4b2.

本文引用的文献

1
Extensive fatal intracoronary thrombosis during percutaneous coronary intervention with bivalirudin.经皮冠状动脉介入治疗中比伐卢定致广泛致命性冠状动脉内血栓形成。
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Intra-procedural stent thrombosis: a new risk factor for adverse outcomes in patients undergoing percutaneous coronary intervention for acute coronary syndromes.术中支架内血栓形成：急性冠脉综合征行经皮冠状动脉介入治疗患者不良结局的一个新的危险因素。
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Consensus standards for acquisition, measurement, and reporting of intravascular optical coherence tomography studies: a report from the International Working Group for Intravascular Optical Coherence Tomography Standardization and Validation.血管内光学相干断层扫描研究的获取、测量和报告的共识标准：来自血管内光学相干断层扫描标准化和验证国际工作组的报告。
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4
Acute stent thrombosis: technical complication or inadequate antithrombotic therapy? An optical coherence tomography study.急性支架血栓形成：技术并发症还是抗栓治疗不足？一项光学相干断层扫描研究。
JACC Cardiovasc Interv. 2012 Feb;5(2):e3-4. doi: 10.1016/j.jcin.2011.09.026.
5
Case report: a thrombus in the venous reservoir while using bivalirudin in a patient with heparin-induced thrombocytopenia undergoing heart transplantation.病例报告：在接受肝素诱导的血小板减少症的心脏移植患者中使用比伐卢定期间，静脉储液器中出现血栓。
Anesth Analg. 2010 Sep;111(3):609-12. doi: 10.1213/ANE.0b013e3181e9ead3. Epub 2010 Aug 4.
6
Clinical end points in coronary stent trials: a case for standardized definitions.冠状动脉支架试验中的临床终点：标准化定义的必要性
Circulation. 2007 May 1;115(17):2344-51. doi: 10.1161/CIRCULATIONAHA.106.685313.
7
Intracoronary macrothrombus formation during percutaneous coronary intervention despite optimal activated clotting time using bivalirudin--a case report.尽管使用比伐卢定使活化凝血时间达到最佳，但经皮冠状动脉介入治疗期间仍发生冠状动脉内大血栓形成——病例报告
Angiology. 2005 Nov-Dec;56(6):761-5. doi: 10.1177/000331970505600614.
8
Bivalirudin (Angiomax) use during intracoronary brachytherapy may predispose to acute closure.在冠状动脉内近距离放射治疗期间使用比伐卢定（Angiomax）可能会导致急性血管闭塞。
J Cardiovasc Pharmacol Ther. 2003 Mar;8(1):9-15. doi: 10.1177/107424840300800i103.