使用3.5毫米外周血管内超声碎石球囊治疗重度钙化冠状动脉狭窄：病例系列
Treatment of heavily calcified coronary artery stenosis using 3.5 mm peripheral intravascular lithotripsy balloon: case series.
作者信息
Mekala Karthik, Mehta Rajendra H, Joumaa Mouhammed, Yamasaki Hiroshi
机构信息
Department of Cardiology, Ascension St. John Hospital, 22101 Moross Rd, Detroit, Michigan 48236, USA.
Duke Clinical Research Institute, 200 Morris St., Durham, NC 27701, USA.
出版信息
Eur Heart J Case Rep. 2020 Sep 10;4(5):1-5. doi: 10.1093/ehjcr/ytaa211. eCollection 2020 Oct.
BACKGROUND
Prevalence of coronary artery calcification is high among patients with advanced age, chronic kidney disease, and diabetes. Percutaneous coronary intervention of heavily calcified coronary artery remains a significant challenge for interventional cardiologists. Although there are several modalities available in treating calcified coronary arteries, lesion preparation of certain heavily calcified vessels remains inadequate prior to stent deployment and/or often associated with worse periprocedural adverse outcomes.
CASE SUMMARY
We report feasibility and safety of 3.5 mm peripheral intravascular lithotripsy (IVL) for the treatment of severely calcified coronary stenosis in two patients after orbital atherectomy failed to debulk calcified plaque to enable stent deployment.
DISCUSSION
Intravascular lithotripsy has recently emerged as a therapeutic option in treating calcified peripheral artery disease. However, coronary IVL is currently available only in a few centres in the USA. Studies are ongoing in the safety and efficacy of this technology in treating coronaries.
背景
在高龄、慢性肾脏病和糖尿病患者中，冠状动脉钙化的患病率很高。严重钙化冠状动脉的经皮冠状动脉介入治疗对介入心脏病学家来说仍然是一项重大挑战。尽管在治疗钙化冠状动脉方面有多种方法可用，但在某些严重钙化血管的病变预处理中，在支架置入前仍不充分，和/或常常伴有更差的围手术期不良后果。
病例总结
我们报告了两例患者在眼眶斑块旋切术未能使钙化斑块减容以实现支架置入后，采用3.5毫米外周血管内冲击波碎石术（IVL）治疗严重钙化冠状动脉狭窄的可行性和安全性。
讨论
血管内冲击波碎石术最近已成为治疗钙化外周动脉疾病的一种治疗选择。然而，冠状动脉IVL目前仅在美国的少数几个中心可用。关于该技术治疗冠状动脉的安全性和有效性的研究正在进行中。
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