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支架错位至间隔穿孔动脉：右心室瘘、室间隔血肿和右心室流出道梗阻。

A Stent Misplaced in the Septal Perforating Artery: Right Ventricular Fistula, Interventricular Septal Hematoma, and Right Ventricular Outflow Tract Obstruction.

机构信息

Department of Cardiology Trakya University Faculty of Medicine, Edirne - Turquia.

Department of Radiology Trakya University Faculty of Medicine, Edirne - Turquia.

出版信息

Arq Bras Cardiol. 2023 Sep 4;120(8):e20220901. doi: 10.36660/abc.20220901. eCollection 2023.

DOI:10.36660/abc.20220901
PMID:37672407
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10519249/
Abstract

Coronary-cameral fistulas, though mostly regarded as congenital entities, have also been encountered as complications of major traumas and percutaneous coronary interventions (PCIs).1 On the other hand, interventricular septal (IVS) hematoma might potentially arise mostly during retrograde chronic total occlusion (CTO) interventions and has a benign course in this context.2 Herein, we describe a challenging PCI complication (and its management strategy) presenting with IVS hematoma, right ventricular fistula, and right ventricular outflow tract (RVOT) obstruction due to a misimplanted coronary stent in the septal perforating artery (SPA).

摘要

冠状窦-心腔瘘，虽然大多被认为是先天性的，但也有作为重大创伤和经皮冠状动脉介入治疗（PCIs）的并发症出现。1 另一方面，室间隔（IVS）血肿主要可能在逆行慢性完全闭塞（CTO）介入过程中发生，在这种情况下具有良性过程。2 在此，我们描述了一种具有挑战性的 PCI 并发症（及其管理策略），其表现为 IVS 血肿、右心室瘘和右心室流出道（RVOT）阻塞，原因是冠状动脉支架误植入间隔穿支动脉（SPA）。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/227e/10519249/3191c9b0f823/0066-782X-abc-120-08-e20220901-gf05-en.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/227e/10519249/860b4de99ca9/0066-782X-abc-120-08-e20220901-gf01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/227e/10519249/d598a2beee7a/0066-782X-abc-120-08-e20220901-gf02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/227e/10519249/3ea6080b0539/0066-782X-abc-120-08-e20220901-gf03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/227e/10519249/bd628c97c5f4/0066-782X-abc-120-08-e20220901-gf04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/227e/10519249/f5b0ad5dd55b/0066-782X-abc-120-08-e20220901-gf05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/227e/10519249/adb492d3c9c2/0066-782X-abc-120-08-e20220901-gf01-en.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/227e/10519249/7ec0dfdc917b/0066-782X-abc-120-08-e20220901-gf02-en.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/227e/10519249/66dcb4c1270a/0066-782X-abc-120-08-e20220901-gf03-en.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/227e/10519249/39ec2ee7d191/0066-782X-abc-120-08-e20220901-gf04-en.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/227e/10519249/3191c9b0f823/0066-782X-abc-120-08-e20220901-gf05-en.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/227e/10519249/860b4de99ca9/0066-782X-abc-120-08-e20220901-gf01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/227e/10519249/d598a2beee7a/0066-782X-abc-120-08-e20220901-gf02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/227e/10519249/3ea6080b0539/0066-782X-abc-120-08-e20220901-gf03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/227e/10519249/bd628c97c5f4/0066-782X-abc-120-08-e20220901-gf04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/227e/10519249/f5b0ad5dd55b/0066-782X-abc-120-08-e20220901-gf05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/227e/10519249/adb492d3c9c2/0066-782X-abc-120-08-e20220901-gf01-en.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/227e/10519249/7ec0dfdc917b/0066-782X-abc-120-08-e20220901-gf02-en.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/227e/10519249/66dcb4c1270a/0066-782X-abc-120-08-e20220901-gf03-en.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/227e/10519249/39ec2ee7d191/0066-782X-abc-120-08-e20220901-gf04-en.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/227e/10519249/3191c9b0f823/0066-782X-abc-120-08-e20220901-gf05-en.jpg

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本文引用的文献

1
Management of Coronary Artery Perforation.冠状动脉穿孔的处理。
Cardiovasc Revasc Med. 2021 May;26:55-60. doi: 10.1016/j.carrev.2020.11.013. Epub 2020 Nov 12.
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A case report of an iatrogenic coronary cameral fistula treated by retrograde percutaneous coronary intervention.经皮冠状动脉逆行介入治疗医源性冠状动脉心腔瘘1例报告
Eur Heart J Case Rep. 2020 May 3;4(3):1-6. doi: 10.1093/ehjcr/ytaa094. eCollection 2020 Jun.
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Incidence, Treatment, and Outcomes of Coronary Perforation During Chronic Total Occlusion Percutaneous Coronary Intervention.
慢性完全闭塞性经皮冠状动脉介入治疗期间冠状动脉穿孔的发生率、治疗及结局
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Interventricular Septal Hematoma and Coronary-Ventricular Fistula: A Complication of Retrograde Chronic Total Occlusion Intervention.室间隔血肿与冠状-心室瘘：逆行性慢性完全闭塞病变介入治疗的一种并发症
Case Rep Cardiol. 2016;2016:8750603. doi: 10.1155/2016/8750603. Epub 2016 Sep 7.
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Incidence, Determinants, and Outcomes of Coronary Perforation During Percutaneous Coronary Intervention in the United Kingdom Between 2006 and 2013: An Analysis of 527 121 Cases From the British Cardiovascular Intervention Society Database.2006 年至 2013 年期间英国经皮冠状动脉介入治疗中冠状动脉穿孔的发生率、决定因素和转归：英国心血管介入学会数据库中 527121 例病例分析。
Circ Cardiovasc Interv. 2016 Aug;9(8). doi: 10.1161/CIRCINTERVENTIONS.115.003449.