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因右冠状动脉冠状动脉介入治疗相关的窦性停搏导致的心源性脑栓塞:一例报告。

Cardiogenic cerebral embolism due to sinus arrest associated with coronary intervention for the right coronary artery: A case report.

作者信息

Seki Toshiki, Tokita Yukichi, Shimizu Wataru, Takano Hitoshi

机构信息

Department of Cardiovascular Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan.

出版信息

J Cardiol Cases. 2021 Oct 23;25(4):210-212. doi: 10.1016/j.jccase.2021.09.010. eCollection 2022 Apr.

Abstract

Percutaneous coronary artery intervention (PCI) carries the risk of occlusion of the sinus node branch (SNB) which can lead to sinus arrest (SA). Generally, PCI-related SA recovers spontaneously, with a favorable clinical course. Herein, we describe a case of SNB occlusion after PCI for the right coronary artery which resulted in SA, subsequent left atrial appendage thrombus, and cardiogenic cerebral embolism (CE). Ultimately, the patient died due to cardiogenic CE. We report on the mechanism of intracardiac thrombus formation and discuss CE prevention strategies after PCI. Based on our experience, the possibility of adverse events due to PCI-induced SA must be considered, although PCI-induced SA is generally expected to resolve. < Percutaneous coronary artery intervention (PCI) carries the risk of occlusion of the side branches, including the sinus node branch (SNB). The occlusion of the SNB can lead to sinus arrest (SA). Generally, PCI-related SA recovers spontaneously. However, it should be noted that persistent SA can result in thrombus formation and cerebral embolism.>.

摘要

经皮冠状动脉介入治疗(PCI)存在导致窦房结分支(SNB)闭塞的风险,这可能会引发窦性停搏(SA)。一般来说,PCI相关的SA会自发恢复,临床病程良好。在此,我们描述了一例因右冠状动脉PCI术后发生SNB闭塞,进而导致SA、随后出现左心耳血栓和心源性脑栓塞(CE)的病例。最终,患者因心源性CE死亡。我们报告了心内血栓形成的机制,并讨论了PCI术后CE的预防策略。根据我们的经验,尽管PCI引起的SA一般预期会自行缓解,但仍必须考虑PCI诱发SA导致不良事件的可能性。<经皮冠状动脉介入治疗(PCI)存在包括窦房结分支(SNB)在内的侧支闭塞风险。SNB闭塞可导致窦性停搏(SA)。一般而言,PCI相关的SA会自发恢复。然而,应注意持续性SA可导致血栓形成和脑栓塞。>

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5baf/9326011/41e8a46f7abe/gr1.jpg

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