Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
Hubei Key Laboratory of Biological Targeted Therapy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
BMC Cardiovasc Disord. 2023 Apr 11;23(1):190. doi: 10.1186/s12872-023-03215-w.
In current percutaneous coronary intervention (PCI) practice, the balloon used in the procedure should be deflated a short time after balloon dilation to avoid having prolonged balloon dilation in the coronary artery, which would block the coronary artery and cause myocardial ischemia. It is very rare for a dilated stent balloon to fail to deflate. A 44-year-old male was admitted to the hospital due to chest pain after exercise. Coronary angiography showed severe proximal stenosis of the right coronary artery (RCA) consistent with a diagnosis of coronary artery disease, and coronary stent implantation was required. After the last stent balloon was dilated, the stent balloon could not be deflated and continued to expand, resulting in blockage of the RCA blood flow. The patient then suffered decreased blood pressure and heart rate. Finally, the stent balloon in its expanded state was forcefully and directly withdrawn from the RCA and successfully removed from the body.
Deflation failure of a stent balloon is an extremely rare complication of PCI. Various treatment strategies can be considered based on hemodynamic status. In the case described herein, the balloon was pulled out of the RCA directly to restore blood flow, which kept the patient safe.
在当前的经皮冠状动脉介入治疗(PCI)实践中,球囊在扩张后应短时间内放气,以避免冠状动脉内长时间扩张,从而阻塞冠状动脉并导致心肌缺血。扩张后的支架球囊未能放气的情况非常罕见。一名 44 岁男性因运动后胸痛而入院。冠状动脉造影显示右冠状动脉(RCA)近端严重狭窄,符合冠心病诊断,需要进行冠状动脉支架植入术。最后一个支架球囊扩张后,支架球囊无法放气并持续扩张,导致 RCA 血流受阻。随后患者出现血压和心率下降。最终,扩张状态的支架球囊被强行直接从 RCA 中拔出,并成功从体内取出。
支架球囊放气失败是 PCI 极罕见的并发症。可根据血流动力学状态考虑各种治疗策略。在本文所述病例中,直接从 RCA 中拉出球囊以恢复血流,使患者安全。