Fang Jonathan Xinguo, Yung Arthur Sze-Yue, Lam Simon Cheung-Chi, Tam Frankie Chor-Cheung
Division of Cardiology, Department of Medicine, Queen Mary Hospital, Li Ka Shing Faculty of Medicine, University of Hong Kong Hong Kong, China.
Interv Cardiol. 2022 Sep 23;17:e12. doi: 10.15420/icr.2021.18. eCollection 2022 Jan.
Calcified disease increases procedural challenges and is associated with worse outcomes in percutaneous coronary intervention. Coronary intravascular lithotripsy is a new balloon-based modality for treating calcified disease with deep circumferential calcification. Its main benefit is simplicity and safety compared to atherectomy. However, atherectomy remains the modality of choice in balloon-uncrossable lesions. More than one modality is often needed for treatment of calcified disease. The authors present a case of a balloon-uncrossable calcified ostial left circumflex lesion which was first treated with rotational atherectomy. However, there was haematoma formation in the ostial circumflex extending into left main coronary artery, together with suboptimal preparation of calcified disease. Intravascular coronary lithotripsy was then used to successfully prepare the calcified lesion for stenting without causing extension of the haematoma.
钙化性疾病增加了手术难度，并与经皮冠状动脉介入治疗的不良预后相关。冠状动脉血管内碎石术是一种新的基于球囊的治疗伴有深部环形钙化的钙化性疾病的方法。与旋切术相比，其主要优点是操作简单且安全。然而，对于球囊无法通过的病变，旋切术仍是首选的治疗方式。钙化性疾病的治疗通常需要不止一种治疗方式。作者介绍了一例球囊无法通过的左回旋支开口处钙化病变病例，该病例首先接受了旋磨术治疗。然而，在回旋支开口处形成了血肿，并延伸至左主干冠状动脉，同时钙化性疾病的预处理效果欠佳。随后使用冠状动脉血管内碎石术成功地对钙化病变进行了预处理，以便进行支架置入，且未导致血肿扩大。
