Division of Cardiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
Division of Cardiology, Central Arkansas Veterans Health Care System, Little Rock, Arkansas.
Catheter Cardiovasc Interv. 2020 May 1;95(6):1136-1140. doi: 10.1002/ccd.28399. Epub 2019 Jul 16.
Coronary perforation remains a dreaded complication of chronic total occlusion (CTO) percutaneous coronary intervention (PCI). We present a case of successful CTO recanalization complicated by a perforation treated by n-butyl-cyanoacrylate (medical "super-glue"). We also present an in vitro experiment showing that a glue plug in a plastic tube can acutely be passed by a low tip load guide wire and undergo balloon angioplasty recreating a lumen. These results suggest that n-butyl-cyanoacrylate glue may be an alternative for treating perforation during CTO PCI with the possibility of recanalizing the vessel through the glue plug at a later time.
冠状动脉穿孔仍然是慢性完全闭塞（CTO）经皮冠状动脉介入治疗（PCI）的一种可怕并发症。我们报告了一例成功的 CTO 再通后并发穿孔的病例，采用氰基丙烯酸正丁酯（医用“超级胶水”）治疗。我们还进行了一项体外实验，显示塑料管内的胶塞可以在低尖端负荷导丝的作用下急性通过，并进行球囊血管成形术，从而重新形成管腔。这些结果表明，氰基丙烯酸正丁酯胶可能是治疗 CTO PCI 穿孔的一种替代方法，以后有可能通过胶塞再通血管。
