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一名患有冠状动脉扩张症患者的多支罪犯冠状动脉血栓形成

Multiple Culprit Coronary Artery Thrombosis in a Patient with Coronary Ectasia.

作者信息

Matte Bruno da Silva, de Araujo Gustavo Neves, Valle Felipe Homem, Krepsky Ana Maria Rocha

机构信息

Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.

出版信息

Case Rep Cardiol. 2018 Jan 14;2018:6148470. doi: 10.1155/2018/6148470. eCollection 2018.

DOI:10.1155/2018/6148470
PMID:29854473
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5821975/
Abstract

We here report a case of ST-elevation myocardial infarction (STEMI) due to simultaneous acute coronary artery occlusions of two major coronary arteries in a patient with coronary ectasia. The patient had been previously submitted to percutaneous coronary angioplasty with bare metal stent implantation in both culprit vessels. Very late stent thrombosis could be the cause of the first occlusion, triggering the event in the other vessel. In addition, concomitant embolic sources were not identified. Although routine aspiration thrombectomy in STEMI was not proven to be beneficial in randomized clinical trials, it was of great value in this case. We also discuss the relation between coronary ectasia, chronic inflammatory status, and increased platelet activity which may have caused plaque disruption in another already vulnerable vessel.

摘要

我们在此报告一例因冠状动脉扩张患者的两条主要冠状动脉同时发生急性冠状动脉闭塞而导致的ST段抬高型心肌梗死（STEMI）。该患者此前已在两条罪犯血管中接受了裸金属支架植入的经皮冠状动脉成形术。极晚期支架血栓形成可能是首次闭塞的原因，从而引发了另一血管中的事件。此外，未发现伴随的栓子来源。尽管在随机临床试验中未证明STEMI的常规血栓抽吸术有益，但在本病例中具有重要价值。我们还讨论了冠状动脉扩张、慢性炎症状态与血小板活性增加之间的关系，这些因素可能导致另一本已易损血管中的斑块破裂。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd82/5821975/c419b1452849/CRIC2018-6148470.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd82/5821975/919b001064ab/CRIC2018-6148470.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd82/5821975/5dc464f4838d/CRIC2018-6148470.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd82/5821975/c419b1452849/CRIC2018-6148470.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd82/5821975/919b001064ab/CRIC2018-6148470.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd82/5821975/5dc464f4838d/CRIC2018-6148470.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd82/5821975/c419b1452849/CRIC2018-6148470.003.jpg

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