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一例自发性冠状动脉夹层并发支架断裂的病例报告。

A case report of spontaneous coronary artery dissection complicated by stent fracture.

作者信息

Gao Hanxiang, Hu Ye, Li Qi, Yao Suyu, Zhang Zheng, Bai Ming

机构信息

Department of Cardiology, First Hospital of Lanzhou University, Lanzhou, Gansu, China.

出版信息

Medicine (Baltimore). 2019 Aug;98(35):e16612. doi: 10.1097/MD.0000000000016612.

Abstract

RATIONALE

Spontaneous coronary artery dissection (SCAD) is a rare, complex disease, and nowadays poorly understood. The overall incidence of SCAD ranges from 0.28% to 1.1% in angiographic studies. Therefore, the true incidence of SCAD is most likely underestimated due to asymptomatic or sudden cardiac death before diagnosis. Stent fracture (SF) is a multifactorial issue. Longer vessel remodeled by 2 stents can be more prone to have SF due to higher radial force.

PATIENT CONCERNS

In this paper we report a 48-year-old man with chest pain for 2 years.

DIAGNOSES

Elective coronary angiography revealed a linear dissection in obtuse marginal branch (OM).

INTERVENTIONS

He underwent percutaneous coronary intervention (PCI) with the guidance of intravascular ultrasound (IVUS).

OUTCOMES

Then SF was revealed 9 months later.

LESSONS

This is the first case report of SF after coronary intervention therapy in SCAD patients.

摘要

理论依据

自发性冠状动脉夹层(SCAD)是一种罕见的复杂疾病,目前人们对其了解甚少。血管造影研究显示,SCAD的总体发病率在0.28%至1.1%之间。因此,由于在诊断前出现无症状或心源性猝死,SCAD的真实发病率很可能被低估。支架断裂(SF)是一个多因素问题。由于较高的径向力,用2个支架重塑的较长血管更容易发生SF。

患者情况

在本文中,我们报告了一名48岁胸痛2年的男性患者。

诊断

选择性冠状动脉造影显示钝缘支(OM)有线性夹层。

干预措施

他在血管内超声(IVUS)引导下接受了经皮冠状动脉介入治疗(PCI)。

结果

9个月后发现支架断裂。

经验教训

这是SCAD患者冠状动脉介入治疗后发生支架断裂的首例病例报告。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6904/6736166/ec7e65e4540a/medi-98-e16612-g001.jpg

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