Guenot O, Cristofini P, Desnos M, Hagège A
Service de cardiologie, hôpital Boucicaut, Paris.
Arch Mal Coeur Vaiss. 1988 Mar;81(3):335-8.
The authors report a case of percutaneous dilatation of a coronary artery performed immediately after a mild myocardial infarction and complicated by occlusive thrombosis without dissection, despite a presumably effective anticoagulant treatment. A second dilatation resulted in rapid recanalization of the artery, but recurrent thrombosis developed at the site of dilatation. The thrombotic process was controlled with an intracoronary infusion of urokinase and higher doses of intravenous heparin, but only after a long delay (80 minutes). This case suggests that in similar circumstances one must wait long enough before referring the patient to a surgical unit for emergency aorto-coronary bypass.
作者报告了一例在轻度心肌梗死后立即进行冠状动脉经皮扩张术的病例，尽管进行了可能有效的抗凝治疗，但仍并发了无夹层的闭塞性血栓形成。第二次扩张使动脉迅速再通，但在扩张部位又发生了血栓形成。通过冠状动脉内输注尿激酶和更高剂量的静脉肝素控制了血栓形成过程，但延迟了很长时间（80分钟）。该病例表明，在类似情况下，在将患者转诊至外科单位进行紧急主动脉冠状动脉搭桥手术之前，必须等待足够长的时间。
