Department of Cardiology, Xuzhou Central Hospital, Jiangsu Province, China.
Medicine (Baltimore). 2023 Mar 3;102(9):e32839. doi: 10.1097/MD.0000000000032839.
Coronary pseudoaneurysm (CPA) are associated with iatrogenic coronary artery dissection or perforation, which rarely reported formation early after percutaneous coronary intervention (PCI) for chronic total occlusion (CTO). This study reported a case of CPA that developed 4 weeks after PCI for CTO.
A 40-year-old man was admitted with unstable angina and diagnosed with CTO of the left anterior descending artery (LAD) and right coronary artery. The CTO of the LAD was successfully treated by PCI. However, reexamination by coronary arteriography and optical coherence tomography after 4 weeks confirmed a CPA at the stented middle segment of the LAD. The CPA was treated surgically by the implantation of a Polytetrafluoroethylene-coated stent. reexamination at the 5-month follow-up revealed a patent stent in the LAD and no CPA-like manifestations. Intravascular ultrasound showed no intimal hyperplasia or in-stent thrombogenesis.
CPA might develop within weeks after PCI for CTO. While it could be successfully treated by the implantation of a Polytetrafluoroethylene-coated stent.
冠状动脉假性动脉瘤（CPA）与医源性冠状动脉夹层或穿孔有关，在慢性完全闭塞（CTO）经皮冠状动脉介入治疗（PCI）后早期很少有报道形成。本研究报告了一例 CTO 经 PCI 治疗 4 周后发生 CPA 的病例。
一名 40 岁男性因不稳定型心绞痛入院，诊断为左前降支（LAD）和右冠状动脉 CTO。LAD 的 CTO 通过 PCI 成功治疗。然而，4 周后行冠状动脉造影和光学相干断层扫描复查证实 LAD 支架中段存在 CPA。CPA 通过植入聚四氟乙烯涂层支架进行手术治疗。5 个月随访时复查显示 LAD 内支架通畅，无 CPA 样表现。血管内超声显示无内膜增生或支架内血栓形成。
CPA 可能在 CTO 经 PCI 治疗后数周内发生。虽然可以通过植入聚四氟乙烯涂层支架成功治疗。
