Oshima Tsukasa, Minatsuki Shun, Myojo Masahiro, Kodera Satoshi, Nawata Kan, Ando Jiro, Akazawa Hiroshi, Watanabe Masafumi, Ono Minoru, Komuro Issei
Department of Cardiovascular Medicine, The University of Tokyo Hospital.
Department of Cardiac Surgery, The University of Tokyo Hospital.
Int Heart J. 2018;59(1):203-208. doi: 10.1536/ihj.17-081.
Coronary stent fracture (SF) is rare as a complication of percutaneous coronary intervention (PCI), and its adverse events are increasingly being recognized with the development in devices of PCI. The major adverse events caused by SFs are in-stent restenosis due to neointimal overgrowth caused by poor drug delivery. A coronary artery aneurysm (CAA) is a rare complication of SF, but may lead to lethal events such as acute coronary syndrome or rupture of the CAA further leading to cardiac tamponade. However, the management of CAAs is controversial with or without SF. Herein, we report a case of a CAA caused by an SF and discuss the management of CAA complicated with SF, along with a literature review. We suggest that surgical treatment should be considered the higher-priority strategy in the cases of CAA with SF as compared to CAA without SF.
冠状动脉支架断裂（SF）作为经皮冠状动脉介入治疗（PCI）的并发症较为罕见，随着PCI器械的发展，其不良事件越来越受到关注。SF导致的主要不良事件是由于药物递送不佳引起的新生内膜过度增生导致的支架内再狭窄。冠状动脉瘤（CAA）是SF的一种罕见并发症，但可能导致致命事件，如急性冠状动脉综合征或CAA破裂进而导致心脏压塞。然而，无论有无SF，CAA的治疗都存在争议。在此，我们报告一例由SF引起的CAA病例，并讨论合并SF的CAA的治疗，同时进行文献复习。我们建议，与无SF的CAA相比，对于合并SF的CAA病例，应将手术治疗视为更优先的策略。
