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以ST段抬高型心肌梗死为表现的巨大冠状动脉瘤的非常规治疗：一例报告

Unconventional treatment of a giant coronary aneurysm presenting as ST-elevation myocardial infarction: a case report.

作者信息

Barioli Alberto, Pellizzari Nicola, Favero Luca, Cernetti Carlo

机构信息

Cardiology Unit, Cardio-Neuro-Vascular Department, Ca' Foncello Hospital Azienda N 2 Marca Trevigiana, Via Sant'Ambrogio, 37, 31100 Treviso, Italy.

出版信息

Eur Heart J Case Rep. 2021 Oct 1;5(10):ytab385. doi: 10.1093/ehjcr/ytab385. eCollection 2021 Oct.

DOI:10.1093/ehjcr/ytab385
PMID:34738061
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8564704/
Abstract

BACKGROUND

The optimal treatment of aneurysmal or ectatic culprit vessels in the setting of acute myocardial infarction is still matter of debate, as revascularization with either percutaneous intervention or surgery is associated with low procedural success and poor outcomes.

CASE SUMMARY

We report the case of a 55-year-old male patient, admitted for inferior ST-elevation myocardial infarction, who underwent successful percutaneous implantation of a micro-mesh self-expanding nitinol carotid stent in a right coronary aneurysm with intravascular ultrasonography measured diameter of 9 mm and massive thrombus apposition.

DISCUSSION

The technical characteristics of the micro-mesh self-expanding nitinol carotid stent allow for adequate plaque coverage and good apposition even in large vessels, making this device particularly suitable for the treatment of coronary lesions with high thrombus burden, when severe coronary ectasia or aneurysms are present.

摘要

背景

在急性心肌梗死情况下，对动脉瘤样或扩张性罪犯血管的最佳治疗仍存在争议，因为经皮介入或手术的血运重建与手术成功率低和预后不良相关。

病例摘要

我们报告了一名55岁男性患者的病例，该患者因下壁ST段抬高型心肌梗死入院，在血管内超声测量直径为9mm且有大量血栓附着的右冠状动脉瘤中成功进行了微网自膨式镍钛合金颈动脉支架的经皮植入。

讨论

微网自膨式镍钛合金颈动脉支架的技术特性即使在大血管中也能实现足够的斑块覆盖和良好的贴合，使得该装置特别适用于存在严重冠状动脉扩张或动脉瘤且血栓负荷高的冠状动脉病变的治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c7fa/8564704/7e4af73206de/ytab385f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c7fa/8564704/2e72f16a1fa6/ytab385f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c7fa/8564704/cf4a2d83f7f1/ytab385f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c7fa/8564704/3f4f2b46b963/ytab385f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c7fa/8564704/77b2de6740a2/ytab385f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c7fa/8564704/7e4af73206de/ytab385f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c7fa/8564704/2e72f16a1fa6/ytab385f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c7fa/8564704/cf4a2d83f7f1/ytab385f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c7fa/8564704/3f4f2b46b963/ytab385f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c7fa/8564704/77b2de6740a2/ytab385f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c7fa/8564704/7e4af73206de/ytab385f5.jpg

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Kardiochir Torakochirurgia Pol. 2017 Sep;14(3):158-163. doi: 10.5114/kitp.2017.70276. Epub 2017 Sep 30.
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Patient Outcomes With STEMI Caused by Aneurysmal Coronary Artery Disease and Treated With Primary PCI.动脉瘤性冠状动脉疾病所致ST段抬高型心肌梗死患者接受直接经皮冠状动脉介入治疗的预后
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