From the Department of Cardiac Imaging, Imaging and Diagnostic Center CID, Americas Avenue 2016, Guadalajara, Jalisco, Mexico (H.G.); Department of Radiology, Western National Medical Center IMSS, Guadalajara, Jalisco, Mexico (H.G., D.d.l.F., M.C.); Department of Radiology, University of Rochester Medical Center, Rochester, NY (A.C.); Department of Radiology, University of Colorado Hospital, Denver, Colo (D.V.); Department of Radiology, Mayo Clinic, Rochester, Minn (P.M.Y., P.R.); and Department of Radiology, UT Health Science Center, San Antonio, Tex (S.S.S.).
Radiographics. 2021 May-Jun;41(3):699-719. doi: 10.1148/rg.2021200147. Epub 2021 Apr 2.
Coronary artery interventions and surgical procedures are used in the treatment of coronary artery disease and some congenital heart diseases. Cardiac and noncardiac complications can occur at variable times after these procedures, with the clinical presentation ranging from asymptomatic to devastating symptoms. Invasive coronary angiography is the reference standard modality used in the evaluation of coronary arteries, with intravascular US and optical coherence tomography providing high-resolution information regarding the vessel wall. CT is the mostly commonly used noninvasive imaging modality in the evaluation of coronary artery intervention complications and allows assessment of the stent, lumen of the stent, lumen of the coronary arteries, and extracoronary structures. MRI is limited to the evaluation of the proximal coronary arteries but allows comprehensive evaluation of the myocardium, including ischemia and infarction. The authors review the clinical symptoms and pathophysiologic and imaging features of various complications of coronary artery interventions and surgical procedures. Complications of percutaneous coronary interventions are discussed, including restenosis, thrombosis, dissection of coronary arteries or the aorta, coronary wall rupture or perforation, stent deployment failure, stent fracture, stent infection, stent migration or embolism, and reperfusion injury. Complications of several surgical procedures are reviewed, including coronary artery bypass grafting, coronary artery reimplantation procedure (for anomalous origin from opposite sinuses or the pulmonary artery or as part of surgical procedures such as arterial switching surgery and the Bentall and Cabrol procedures), coronary artery unroofing, and the Takeuchi procedure. RSNA, 2021.
冠状动脉介入和手术用于治疗冠状动脉疾病和一些先天性心脏病。这些手术之后，在不同时间会发生心脏和非心脏并发症，临床表现从无症状到严重症状不等。血管内超声和光学相干断层扫描等血管内成像技术为血管壁提供了高分辨率信息，是评估冠状动脉的金标准方法。CT 是评估冠状动脉介入并发症最常用的无创成像方式，可评估支架、支架内腔、冠状动脉内腔和冠状动脉外结构。MRI 仅限于评估近端冠状动脉，但可全面评估心肌，包括缺血和梗死。作者回顾了冠状动脉介入和手术并发症的临床症状、病理生理和影像学特征。讨论了经皮冠状动脉介入治疗的并发症，包括再狭窄、血栓形成、冠状动脉或主动脉夹层、冠状动脉壁破裂或穿孔、支架置入失败、支架断裂、支架感染、支架移位或栓塞以及再灌注损伤。还回顾了几种手术的并发症，包括冠状动脉旁路移植术、冠状动脉再植入术（用于起源于对侧窦或肺动脉的异常或作为动脉调转术和 Bentall 和 Cabrol 手术等手术的一部分）、冠状动脉开窗术和 Takeuchi 术。RSNA，2021 年。
