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冠状动脉介入治疗导致的医源性主动脉根部损伤:早期及随访CT影像学表现

Iatrogenic Aortic Root Injury from Coronary Interventions: Early and Follow-up CT Imaging Findings.

作者信息

Cappellini Luca A, Eberhard Matthias, Templin Christian, Vogt Paul R, Manka Robert, Alkadhi Hatem

机构信息

Institute of Diagnostic and Interventional Radiology (L.A.C., M.E., R.M.), Department of Cardiology, University Heart Center (C.T., R.M.), and Department of Cardiac Surgery (P.R.V.), University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland; and Department of Radiology, Cardiovascular Imaging Unit, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy (L.A.C., H.A.).

出版信息

Radiol Cardiothorac Imaging. 2021 Dec 2;3(6):e210241. doi: 10.1148/ryct.2021210241. eCollection 2021 Dec.

Abstract

Aortic injury represents a rare but potentially fatal complication of invasive coronary angiography. The authors present a series of four patients with aortic injury after invasive coronary angiography and intervention (mean age, 71 years; three women). In three patients, CT showed subintimal staining from undiluted contrast media (CM) in the aortic root with no communication to the aortic lumen. Short-term follow-up CT showed resolution of CM staining in all patients. Classic aortic dissection occurred in one patient, with undiluted CM from invasive angiography in the false lumen in the aortic root. Preliminary evidence suggests that iatrogenic injury from invasive coronary angiography resulting in subintimal CM staining of the aortic wall at CT, without evidence of communication with the lumen of the aortic root, shows favorable short-term outcome. CT Angiography, Percutaneous, Fluoroscopy Supplemental material is available for this article. © RSNA, 2021.

摘要

主动脉损伤是有创冠状动脉造影罕见但可能致命的并发症。作者报告了4例有创冠状动脉造影及介入术后发生主动脉损伤的患者(平均年龄71岁;3名女性)。3例患者CT显示主动脉根部未稀释造影剂(CM)的内膜下染色,与主动脉腔无连通。短期随访CT显示所有患者CM染色均消退。1例患者发生典型主动脉夹层,主动脉根部假腔内有有创血管造影时未稀释的CM。初步证据表明,有创冠状动脉造影导致的医源性损伤在CT上表现为主动脉壁内膜下CM染色,且无与主动脉根部管腔连通的证据,其短期预后良好。CT血管造影、经皮、荧光透视 本文有补充材料。© RSNA,2021。

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