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冠状动脉内碎石术治疗钙化性新动脉粥样硬化支架内再狭窄:一例报告

Intracoronary lithotripsy for calcific neoatherosclerotic in-stent restenosis: a case report.

作者信息

Tizón-Marcos Helena, Rodríguez-Costoya Iris, Tevar Cristina, Vaquerizo Beatriz

机构信息

Cardiology Department, Hospital del Mar, Passeig Marítim 25-29, 08003 Barcelona, Spain.

Heart Diseases Biomedical Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.

出版信息

Eur Heart J Case Rep. 2020 Jun 9;4(4):1-4. doi: 10.1093/ehjcr/ytaa117. eCollection 2020 Aug.

DOI:10.1093/ehjcr/ytaa117
PMID:32974451
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7501907/
Abstract

BACKGROUND

In-stent restenosis is a difficult percutaneous scenario if calcific neoatherosclerosis is the underlying aetiology.

CASE SUMMARY

A 69-year-old diabetic woman with a previous percutaneous coronary intervention on the left anterior descending coronary artery was readmitted for non-ST-elevation myocardial infarction. In-stent restenosis due to calcific neoatherosclerosis was observed by intracoronary imaging during the intervention. Intravascular lithotripsy was used successfully to fracture the underlying calcific plaque. However, the balloon ruptured during treatment although this did not damage the artery.

DISCUSSION

Intravascular lithotripsy is a promising tool for the treatment of extremely calcified lesions including calcific neoatherosclerosis of in-stent restenosis. Balloon rupture is a complication of this new percutaneous treatment that has not previously been described.

摘要

背景

如果潜在病因是钙化性新动脉粥样硬化,支架内再狭窄是一种棘手的经皮治疗情况。

病例摘要

一名69岁的糖尿病女性,既往曾对左前降支冠状动脉进行过经皮冠状动脉介入治疗,因非ST段抬高型心肌梗死再次入院。介入治疗期间通过冠状动脉内成像观察到由钙化性新动脉粥样硬化导致的支架内再狭窄。血管内碎石术成功用于破碎潜在的钙化斑块。然而,治疗期间球囊破裂,尽管未损伤动脉。

讨论

血管内碎石术是治疗极度钙化病变(包括支架内再狭窄的钙化性新动脉粥样硬化)的一种有前景的工具。球囊破裂是这种新型经皮治疗的一种并发症,此前尚未见报道。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/84cd/7501907/e3d3cfc17560/ytaa117f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/84cd/7501907/c023a5f1eb46/ytaa117f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/84cd/7501907/da2aeb2e427d/ytaa117f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/84cd/7501907/e3d3cfc17560/ytaa117f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/84cd/7501907/c023a5f1eb46/ytaa117f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/84cd/7501907/da2aeb2e427d/ytaa117f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/84cd/7501907/e3d3cfc17560/ytaa117f3.jpg

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本文引用的文献

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Intravascular lithotripsy for recurrent restenosis caused by severe calcific neoatherosclerosis.血管内碎石术治疗严重钙化性新动脉粥样硬化所致复发性再狭窄
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Management of in-stent restenosis.支架内再狭窄的处理。
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Early Australian experience with intravascular lithotripsy treatment of severe calcific coronary stenosis: IVL in acute/chronic coronary syndromes.澳大利亚早期血管内碎石术治疗严重钙化性冠状动脉狭窄的经验:急性/慢性冠状动脉综合征中的血管内碎石术
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