Tziatzios Ioannis, Didagelos Matthaios, Votsis Stefanos, Tziatzios Georgios, Hadjimiltiades Stavros
First Department of Cardiology, AHEPA Hospital, Aristotle University, Thessaloniki, Greece.
Interv Med Appl Sci. 2018 Jun;10(2):95-97. doi: 10.1556/1646.10.2018.16.
A 46-year-old man underwent angioplasty of a restenotic bifurcation lesion of the circumflex artery. The procedure required repeated balloon exchanges and during the last balloon inflation, no balloon was visualized. A test injection revealed a massive coronary air embolism due to expulsion of air that had accumulated in the guiding catheter shaft. The patient was rapidly resuscitated from electromechanical dissociation with intracoronary injection of adrenaline and atropine and forceful intracoronary saline injections. Inspection of the balloon revealed a defect and scratch marks at the junction of the wire part and shaft of the monorail balloon, a location that places the air leakage inside the guiding catheter. This is the first report of massive intracoronary air embolism due to an undetectable damage to the shaft of a balloon angioplasty catheter. Recognition of the problem and immediate intervention is vital in limiting the duration of cardiac dysfunction.
一名46岁男性接受了回旋支动脉再狭窄分叉病变的血管成形术。该手术需要反复更换球囊，在最后一次球囊充盈时，球囊无法显影。一次试验注射显示，由于积聚在引导导管轴内的空气被排出，导致大量冠状动脉空气栓塞。通过冠状动脉内注射肾上腺素、阿托品以及强力冠状动脉内盐水注射，患者迅速从电机械分离状态中复苏。对球囊的检查发现，在单轨球囊的导丝部分与轴的连接处有一个缺陷和划痕，该位置导致空气在引导导管内泄漏。这是首例因球囊血管成形术导管轴不可检测的损伤导致大量冠状动脉空气栓塞的报告。认识到问题并立即进行干预对于限制心脏功能障碍的持续时间至关重要。
