Ohara Yoshikazu, Kusunose Mana, Take Yutaka, Sahara Shinji, Banba Kimikazu, Nishimoto Mika, Yamamoto Katsuhito
Division of Cardiology, Kochi Health Sciences Center, Ike 2125-1, Kochi-shi, Kochi 781-8555, Japan.
J Cardiol Cases. 2009 Nov 12;1(2):e102-e105. doi: 10.1016/j.jccase.2009.09.004. eCollection 2010 Apr.
Spontaneous coronary dissection is a rare cause of myocardial ischemia, myocardial infarction, and sudden death. In the present case, we performed stenting only of the severe stenotic lesion of the dissection with a short bare metal stent, and left the remaining long length of dissection vessel untreated. Six months after coronary stenting, follow-up angiography revealed complete healing of the coronary dissection and no significant in-stent restenosis. This case clearly demonstrates the usefulness of intravascular ultrasound (IVUS) imaging in the diagnosis of coronary dissection and IVUS imaging guides to the choice of the best stenting.
自发性冠状动脉夹层是心肌缺血、心肌梗死和猝死的罕见原因。在本病例中，我们仅使用短裸金属支架对夹层的严重狭窄病变进行了支架置入，而未处理夹层血管其余的长段病变。冠状动脉支架置入术后6个月，随访血管造影显示冠状动脉夹层完全愈合，且支架内无明显再狭窄。本病例清楚地证明了血管内超声（IVUS）成像在冠状动脉夹层诊断中的作用，以及IVUS成像对最佳支架置入选择的指导作用。
