Bai Junqin, Dong Zhichao, Pan Lifei, Xia Xunlong, Zhang Bo
Department of Cardiology, First Affiliated Hospital, Dalian Medical University.
Int Heart J. 2020 Sep 29;61(5):1041-1043. doi: 10.1536/ihj.20-064. Epub 2020 Sep 2.
The current treatment of radiation-induced coronary artery disease (RCAD) is comparable to that of generic coronary artery disease (CAD); however, the outcomes of these treatment measures have not been fully examined in RCAD. A 33-year-old woman, without conventional cardiovascular risk factors, presented with left main coronary artery (LMCA) lesions. At the age of 26, she received mediastinal radiation therapy (RT) to treat mixed cellularity Hodgkin lymphoma. One BiodivYsio 3.5 × 18 mm stent was implanted at the LMCA site. At the age of 38, the patient was treated by balloon dilatation because of approximately 50% in-stent stenosis. At the last follow-up in February 2018, when the patient was 51 years old, she no longer complained of chest pain. Coronary angiography showed no de novo or in-stenosis lesions, although optical coherence tomography showed mild neointimal proliferation, calcific plaque, small ruptured intima, and several uncovered struts. The experience of treating this case may shed some light on coronary stenting in coronary lesions caused by RCAD.
目前，放射性冠状动脉疾病（RCAD）的治疗方法与一般冠状动脉疾病（CAD）的治疗方法相当；然而，这些治疗措施在RCAD中的效果尚未得到充分研究。一名33岁的女性，没有传统的心血管危险因素，出现左主干冠状动脉（LMCA）病变。26岁时，她接受了纵隔放射治疗（RT）以治疗混合细胞型霍奇金淋巴瘤。在LMCA部位植入了一枚3.5×18mm的BiodivYsio支架。38岁时，由于支架内狭窄约50%，患者接受了球囊扩张治疗。在2018年2月的最后一次随访中，患者51岁，她不再抱怨胸痛。冠状动脉造影显示没有新发或支架内病变，尽管光学相干断层扫描显示有轻度新生内膜增生、钙化斑块、小的内膜破裂和几个未覆盖的支架。治疗该病例的经验可能为RCAD所致冠状动脉病变的冠状动脉支架置入术提供一些启示。
