Portero-Portaz Juan J, Córdoba-Soriano Juan G, Gallardo-López Arsenio, Jiménez-Mazuecos Jesús M
Haemodynamics and Interventional Cardiology Unit, University Hospital of Albacete, C/ Hermanos Falcó, 02006, Albacete, Spain.
Eur Heart J Case Rep. 2021 Nov 6;5(11):ytab384. doi: 10.1093/ehjcr/ytab384. eCollection 2021 Nov.
Pulmonary veins stenosis (PVS) after atrial fibrillation radiofrequency ablation is an uncommon complication. When it occurs, percutaneous treatment is the preferred approach. There is a lack of standardized procedures, and when stenting restenosis is relatively common.
We present a young patient with recurrence of PVS after first percutaneous treatment. The recurrence of haemoptysis and dyspnoea after treatment in PVS allowed the diagnosis of significant stenosis again in our patient. In the Heart Team, we opted for a new percutaneous treatment, using intravascular ultrasound (IVUS) to optimize the final result.
Nowadays, percutaneous approach is preferred and among percutaneous treatments for PVS, stenting has shown better results than balloon angioplasty (BA). Despite this, experience in in-stent restenosis is limited, and there is a lack of adequate and specific material for its approach. In this case, we present the possible role of the IVUS and the drug-coated BA in this entity.
心房颤动射频消融术后肺静脉狭窄（PVS）是一种罕见的并发症。当它发生时，经皮治疗是首选方法。目前缺乏标准化的治疗程序，并且支架置入术后再狭窄相对常见。
我们报告一名年轻患者，首次经皮治疗后出现PVS复发。该患者PVS治疗后咯血和呼吸困难复发，提示再次出现严重狭窄。在心脏团队中，我们选择了一种新的经皮治疗方法，使用血管内超声（IVUS）来优化最终治疗效果。
目前，经皮治疗是首选方法，在PVS的经皮治疗中，支架置入术比球囊血管成形术（BA）显示出更好的效果。尽管如此，支架内再狭窄的治疗经验有限，且缺乏针对该病症的充分且特定的治疗材料。在本病例中，我们展示了IVUS和药物涂层球囊血管成形术在该病症中的可能作用。
