Miura Yusuke, Koyama Kohei, Kongoji Ken, Soejima Kyoko
Department of Cardiology, Kyorin University School of Medicine, Tokyo, Japan.
Department of Cardiology, Kyorin University School of Medicine, Tokyo, Japan.
Cardiovasc Revasc Med. 2022 Jul;40S:239-242. doi: 10.1016/j.carrev.2021.10.016. Epub 2021 Oct 30.
Intramural hematoma after percutaneous coronary angioplasty is associated with adverse events and requires immediate bail out; however, the optimal treatment approach has not yet been established. Herein, we describe a case of coronary occlusion due to an intramural hematoma following stent implantation in the mid left anterior descending (LAD) coronary artery. Intravascular ultrasound revealed a massive intramural hematoma from the distal edge of the stent to the distal segment of the LAD, and the true lumen was completely compressed. By performing fenestration with a Wolverine™ Cutting Balloon™ (Boston Scientific, Massachusetts, United States), we were able to bail out without additional stenting. In conclusion, a cutting balloon with improved crossability can be an effective management strategy for intramural hematoma.
经皮冠状动脉介入治疗后发生的壁内血肿与不良事件相关，需要立即采取补救措施；然而，最佳治疗方法尚未确立。在此，我们描述一例因左前降支（LAD）冠状动脉中段支架植入术后壁内血肿导致冠状动脉闭塞的病例。血管内超声显示从支架远端边缘至LAD远端节段有巨大壁内血肿，真腔完全受压。通过使用Wolverine™切割球囊™（美国马萨诸塞州波士顿科学公司）进行开窗，我们得以在无需额外植入支架的情况下进行补救。总之，具有更好通过性的切割球囊可能是治疗壁内血肿的有效管理策略。
