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一篇关于生物可吸收血管支架早期和晚期反复血栓形成的病例报告:系列血管造影和光学相干断层成像发现。

A case report of a recurrent early and late Bioresorbable vascular scaffold thrombosis: serial angiography and optical coherence tomography findings.

机构信息

Division of Cardiology, Keimyung University Dongsan Medical Center, 56 Dalseong-Ro, Jung-Gu, Daegu, 700-712, South Korea.

出版信息

BMC Cardiovasc Disord. 2020 Mar 24;20(1):146. doi: 10.1186/s12872-020-01426-z.

Abstract

BACKGROUND

In bioresorbable vascular scaffolds (BVSs), there is some concern about a possible increase in the rate of scaffold thromboses (ScTs). Although several characteristics similarly contribute to the development of both early and late ScTs, there are also clearly different pathomechanisms between the two time-dependent types of thromboses, especially with BVSs.

CASE PRESENTATION

We recently experienced a very rare case of a 69-year-old man who had recurrent early and late ScTs with somewhat differing pathomechanisms as assessed by optical coherence tomography (OCT). For the late ScT, OCT identified a scaffold dismantling in the same place that a peri-strut low intensity area (PLIA) was observed in the previous OCT finding.

CONCLUSION

We report the management of an ScT in a case with findings such as a heterogeneous a BVS degradation, peri-strut low intensity area (PLIA), intraluminal scaffold dismantling, and under-sizing and/or stent malapposition observed in OCT.

摘要

背景

在生物可吸收血管支架(BVS)中,人们对支架内血栓形成(ScT)的发生率增加存在一些担忧。尽管有几个特征同样有助于早期和晚期 ScT 的发生,但这两种依赖时间的血栓形成之间显然存在不同的病理机制,尤其是在 BVS 中。

病例介绍

我们最近遇到了一个非常罕见的病例,一名 69 岁男性反复发生早期和晚期 ScT,通过光学相干断层扫描(OCT)评估,其病理机制有些不同。对于晚期 ScT,OCT 发现支架在同一位置解体,而在前一次 OCT 发现中观察到支架内低强度区域(PLIA)。

结论

我们报告了一例 ScT 的处理情况,该病例的 OCT 检查结果显示 BVS 降解不均匀、支架内低强度区域(PLIA)、管腔内支架解体、支架尺寸过小和/或支架贴壁不良。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/efc9/7092538/4389517ef5eb/12872_2020_1426_Fig1_HTML.jpg

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