Department of Cardiology, Intensive Coronary Care Unit, Emile Muller Hospital, Mulhouse, France.
Catheter Cardiovasc Interv. 2019 Jul 1;94(1):E17-E19. doi: 10.1002/ccd.28186. Epub 2019 Mar 6.
Conservative management is the first-line treatment for spontaneous coronary artery dissection (SCAD) with stable haemodynamic status and thrombolysis in myocardial infarction three flow on angiography. However, in a few very specific patients, recurrent ischemia, or haemodynamic instability necessitates revascularization. Here, we describe a case of successful optical coherence tomography (OCT)-guided percutaneous coronary intervention (PCI) with a cutting balloon. We performed fenestration at multiple decompression sites prior to stenting in an intramural haematoma with luminal compression. Rescue management of SCAD with luminal compression is a critical issue, because SCAD is an emergent clinical condition affecting young patients with a severe prognosis. To our knowledge, there are no large published series evaluating procedural success rates and long-term follow-up of this technique.
对于血流动力学稳定且溶栓治疗心肌梗死（TIMI）血流 3 级的自发性冠状动脉夹层（SCAD）患者，保守治疗是一线治疗方法。然而，在极少数非常特殊的患者中，反复出现缺血或血流动力学不稳定需要进行血运重建。在这里，我们描述了一例成功应用切割球囊行光学相干断层扫描（OCT）指导下经皮冠状动脉介入治疗（PCI）的病例。我们在管腔受压的壁内血肿中于多个减压部位进行开窗，然后进行支架置入。对于伴有管腔受压的 SCAD，挽救性治疗是一个关键问题，因为 SCAD 是一种影响年轻患者且预后严重的紧急临床情况。据我们所知，尚无评估该技术的程序成功率和长期随访的大型已发表系列。
