Kou Zongke, Mao Rui, Gan Yirong, Zhang Yunlong, Li Bing, Kou Xiaoqing, Xie Jing, Zhang Liying, Liang Tianxiang, Xie Dingxiong, Wang Yanzhen
Gansu Institute of Cardiovascular Diseases, Lanzhou, 730050, China.
Deparment of Cardiovascular surgery, The First people's Hospital of Lanzhou City, Lanzhou, 730050, China.
Heliyon. 2024 Feb 1;10(4):e25694. doi: 10.1016/j.heliyon.2024.e25694. eCollection 2024 Feb 29.
To analyse four cases of intervention via the internal mammary artery-anterior descending branch and provide and summarise the clinical treatment experience.
The clinical data of four patients with distal restenosis of a left anterior descending artery (LAD) anastomosis after left internal mammary artery (LIMA)-LAD bypass surgery, who were admitted to the Gansu Institute of Cardiovascular Diseases between March 2013 and April 2022, were retrospectively analysed and reviewed together with the relevant literature.
Among the four patients, one was treated with intracoronary stenting via the internal mammary artery route, two were treated with intracoronary drug-coated balloon dilation (one of whom underwent fractional flow reserve [FFR] testing), and two underwent FFR testing (one of whom had a negative test result until the end of the procedure and continued to take medication during follow-up; the other patient had a positive result and further interventions). There were no deaths or postoperative complications in the group, and the patients were followed up for 4 months to 9 years, with good long-term outcomes.
Percutaneous coronary intervention (PCI) via the internal mammary artery route is safe and effective, and patients with anastomotic distal stenosis or anastomotic stenosis of LAD bypass anastomosis may be considered for PCI via the internal mammary artery route.
分析4例经乳内动脉-前降支干预的病例并总结临床治疗经验。
回顾性分析2013年3月至2022年4月在甘肃省心血管病研究所住院的4例左乳内动脉-左前降支搭桥术后左前降支吻合口远端再狭窄患者的临床资料，并结合相关文献进行复习。
4例患者中，1例行经乳内动脉途径冠状动脉内支架置入术，2例行冠状动脉内药物涂层球囊扩张术（其中1例进行了血流储备分数[FFR]检测），2例进行了FFR检测（其中1例至手术结束时检测结果为阴性，随访期间继续服药；另1例结果为阳性并进行了进一步干预）。该组无死亡及术后并发症发生，患者随访4个月至9年，远期效果良好。
经乳内动脉途径的经皮冠状动脉介入治疗（PCI）安全有效，对于左前降支搭桥吻合口远端狭窄或吻合口狭窄患者，可考虑行经乳内动脉途径的PCI。
