Abdelaziz Abdelaziz Ahmed, Taleb Ahmed Maher Abo
Department of Cardiology, Teachers Hospital, Cairo, Egypt.
Department of Cardiology, Cairo University, Cairo, Egypt.
Heart Views. 2023 Jul-Sep;24(3):157-159. doi: 10.4103/heartviews.heartviews_120_22. Epub 2023 Jul 5.
Advances in stent design and technology have made stent loss during percutaneous coronary interventions rare. When an undeployed stent dislodges in the left main (LM) artery during percutaneous coronary angioplasty, the risk of life-threatening procedural complications is high. We report a 50-year-old male patient, a smoker, with a history of diabetes mellitus and hypertension with typical chest pain on minimal exertion. Electrocardiogram and echo revealed ischemic changes and regional wall motion abnormality. Culotte technique was used. A new 3 mm × 48 mm stent was inserted in the LM-left circumflex (LM-LCX) followed by stenting of the LM-left anterior descending (LM-LAD) ostia with a 3.5 mm × 18 mm stent. The two balloons were rewired and kissed. Stent slippage and dislodging in the LM artery can be corrected using the culotte technique to crush the undeployed stent behind the LM-LCX and LM-LAD stents.
支架设计和技术的进步已使经皮冠状动脉介入治疗期间的支架脱落很少见。当未展开的支架在经皮冠状动脉成形术期间在左主干(LM)动脉中移位时,危及生命的手术并发症风险很高。我们报告一名50岁男性患者,有吸烟史,患有糖尿病和高血压,轻微活动时出现典型胸痛。心电图和超声心动图显示有缺血性改变和局部室壁运动异常。采用了裤裙技术。在左主干-左旋支(LM-LCX)中置入一枚新的3 mm×48 mm支架,随后在左主干-左前降支(LM-LAD)开口处置入一枚3.5 mm×18 mm支架。将两个球囊重新连线并进行球囊对吻扩张。使用裤裙技术将未展开的支架挤压在LM-LCX和LM-LAD支架后方,可纠正LM动脉中的支架滑动和移位。