Adusumalli Srikanth, Gaikwad Niranjan, Raffel Chris, Dautov Rustem
Heart and Lung Institute, The Prince Charles Hospital, Chermside, Queensland, Australia.
University of Queensland, Chermside, Queensland, Australia.
Catheter Cardiovasc Interv. 2019 May 1;93(6):E331-E336. doi: 10.1002/ccd.28114. Epub 2019 Feb 21.
Coronary artery perforation is a rare complication of percutaneous coronary intervention (PCI). Covered stents have been successfully used in these situations. We report a case of ostial left circumflex (LCx) artery perforation during rotablation PCI of left main coronary artery (LMCA) and LCx artery. After failed attempts to balloon tamponade the perforation, a PK Papyrus covered stent was deployed from proximal LCx into LMCA. This resulted in acute exclusion of the left anterior descending (LAD) artery from coronary circulation. Using a dual lumen catheter, a stiff wire was advanced through the side port toward the occluded LAD to fenestrate the membrane of the covered stent. A series of balloons were used to dilate the fenestration in the covered stent to restore a normal flow into the LAD.
冠状动脉穿孔是经皮冠状动脉介入治疗（PCI）的一种罕见并发症。覆膜支架已成功应用于这些情况。我们报告一例在左主干冠状动脉（LMCA）和左旋支动脉（LCx）旋磨PCI期间发生的LCx动脉开口处穿孔病例。在球囊压迫穿孔失败后，将一个PK Papyrus覆膜支架从近端LCx置入LMCA。这导致左前降支动脉（LAD）急性被排除在冠状动脉循环之外。使用双腔导管，一根硬导丝通过侧孔向闭塞的LAD推进，以在覆膜支架膜上开窗。使用一系列球囊扩张覆膜支架上的开窗，以恢复LAD的正常血流。
