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支架植入术在冠状动脉并发症中有时可能失败:医源性左主干冠状动脉血肿的扩展。

Stent Implantation May Fail Sometimes in Coronary Complications: Extension of an Iatrogenic Left Main Coronary Artery Hematoma.

作者信息

Acar Burak, Arıkan Ali Ahmet, Talas Zeki, Celikyurt Umut, Kanko Muhip

机构信息

Department of Cardiology, Kocaeli University Medical Faculty, Kocaeli, Turkey.

Department of Cardiovascular Surgery, Kocaeli University Medical Faculty, Kocaeli, Turkey.

出版信息

J Tehran Heart Cent. 2022 Oct;17(4):249-251. doi: 10.18502/jthc.v17i4.11615.

Abstract

Coronary artery perforations and dissections, associated with cardiac tamponade or acute vessel closure, are life-threatening complications of percutaneous coronary intervention. In some cases, subepicardial hematomas could occur and compress the vessel. A 59-year-old woman was admitted to our hospital with chest pain and was diagnosed with non-ST-elevation myocardial infarction. Coronary angiography showed the total occlusion of the diagonal artery. During the intervention, left main coronary artery dissection and intramural hematoma occurred as coronary complications. The left main coronary artery was stented; however, the extension of the hematoma through the ostium of the left anterior descending artery caused further complications. The patient underwent an urgent coronary artery bypass graft surgery and was discharged on the seventh postoperative day.

摘要

冠状动脉穿孔和夹层分离,伴有心脏压塞或急性血管闭塞,是经皮冠状动脉介入治疗的危及生命的并发症。在某些情况下,可能会发生心外膜下血肿并压迫血管。一名59岁女性因胸痛入院,被诊断为非ST段抬高型心肌梗死。冠状动脉造影显示对角支动脉完全闭塞。在介入治疗过程中,发生了左主干冠状动脉夹层分离和壁内血肿等冠状动脉并发症。对左主干冠状动脉进行了支架置入;然而,血肿通过左前降支动脉开口处的扩展导致了进一步的并发症。该患者接受了紧急冠状动脉旁路移植手术,并于术后第七天出院。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/86cc/10154107/2ae0cd556eb2/JTHC-17-249-g001.jpg

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