冠状动脉内斑块旋切术治疗支架扩张不足所致ST段抬高型心肌梗死
ST-elevation Myocardial Infarction Due to Stent Underexpansion Managed with Coronary Lithoplasty.
作者信息
Tripolino Cesare, Tassone Eliezer Joseph, Morabito Gaetano, Grillo Placido, Missiroli Bindo
机构信息
Cardiology Unit, St. Anna Hospital, Catanzaro, Italy.
出版信息
Rev Recent Clin Trials. 2019;14(4):292-295. doi: 10.2174/1574887114666190927164253.
BACKGROUND
Coronary calcified lesions may limit optimal stent deployment resulting in stent underexpansion, increasing the risk of thrombosis. The Shockwave Lithoplasty System, a new technology combining a balloon angioplasty catheter with the use of sound waves, it is able to break calcium deposits without affecting vascular soft tissue.
CASE PRESENTATION
An 80-year-old Caucasian man with ST elevation myocardial infarction underwent emergent coronary angiography showing complete intrastent thrombosis at the proximal trait of LAD. After thrombus removal, it was evident that stent under-expansion at its proximal edge was caused by vascular calcification. Coronary shockwave lithoplasty was chosen to treat this lesion. After calcium deposits disruption we were able to obtain complete stent expansion.
CONCLUSION
Our case demonstrates the usefulness and safety of the lithoplasty system in the context of ST elevation myocardial infarction.
背景
冠状动脉钙化病变可能会限制支架的最佳展开，导致支架扩张不足，增加血栓形成的风险。冲击波血管成形术系统是一种将球囊血管成形术导管与声波应用相结合的新技术，它能够在不影响血管软组织的情况下破碎钙沉积物。
病例介绍
一名80岁的白种男性，因ST段抬高型心肌梗死接受了急诊冠状动脉造影，结果显示在左前降支近端特征处存在完全支架内血栓形成。血栓清除后，很明显支架近端边缘的扩张不足是由血管钙化引起的。选择冠状动脉冲击波血管成形术来治疗该病变。在钙沉积物破碎后，我们能够实现支架的完全扩张。
结论
我们的病例证明了血管成形术系统在ST段抬高型心肌梗死情况下的有效性和安全性。
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