ST段抬高型心肌梗死期间钙化病变的旋磨术：病例系列及文献综述
Rotational atherectomy for calcified lesions during ST-segment elevation myocardial infarction: a case series and literature review.
作者信息
Brown Kristen N, Jhand Aravdeep S, Chatzizisis Yiannis, Goldsweig Andrew M
机构信息
Division of Cardiovascular Diseases, University of Nebraska Medical Center, 4200 Emile St., Omaha, NE 68198, USA.
Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA.
出版信息
Eur Heart J Case Rep. 2023 May 9;7(5):ytad207. doi: 10.1093/ehjcr/ytad207. eCollection 2023 May.
BACKGROUND
ST elevation myocardial infarction (STEMI) has traditionally been a relative contraindication for the utilization of rotational atherectomy (RA). However, in severely calcified lesions, RA may be necessary to facilitate stent delivery.
CASE SUMMARY
Three patients who present with STEMI are found to have severely calcified lesions on intravascular ultrasound. Equipment was unable to pass the lesions in all three cases. Rotational atherectomy was therefore performed to allow for stent passage. All three cases had achieved successful revascularization with no intraoperative or post-operative complications. The patients remained angina-free the rest of their hospitalization and at the 4 month follow-up.
DISCUSSION
Rotational atherectomy for calcific plaque modification during STEMI when equipment will not pass is a feasible and safe therapeutic option.
背景
传统上，ST段抬高型心肌梗死（STEMI）是旋磨术（RA）应用的相对禁忌证。然而，在严重钙化病变中，可能需要旋磨术以促进支架置入。
病例摘要
3例STEMI患者经血管内超声检查发现有严重钙化病变。在所有3例中，器械均无法通过病变。因此进行了旋磨术以使支架能够通过。所有3例均成功实现血管再通，无术中或术后并发症。患者在住院期间及4个月随访时均无心绞痛发作。
讨论
当器械无法通过时，在STEMI期间对钙化斑块进行旋磨术是一种可行且安全的治疗选择。
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