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通过推雪机现象实现一级冠状动脉穿孔的闭合。

The Closure of Grade 1 Coronary Perforation by the Snowplow Phenomenon.

作者信息

Mahanta Dibyasundar, Banerjee Anindya, Kumar Abhinav, Deb Pranjit, Karthik Kowtarapu Sai, Mohanan Saran P, Malla Sindhu Rao, Das Debasish

机构信息

Cardiology, SUM Hospital, Bhubaneswar, IND.

Cardiology, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar, IND.

出版信息

Cureus. 2024 Feb 24;16(2):e54818. doi: 10.7759/cureus.54818. eCollection 2024 Feb.

DOI:10.7759/cureus.54818
PMID:38529467
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10962301/
Abstract

We report an extremely rare case of spontaneous closure of grade 1 coronary perforation by the snowplow phenomenon during the revascularization of a subtotal occlusion in the left anterior descending coronary artery. Coronary artery perforation is usually a nightmare during coronary intervention in the cardiac catheterization laboratory. While large coronary perforation requires the deployment of a covered stent, small perforations require heparin reversal, prolonged balloon inflation, deployment of small coils, or gel foam closure. The coronary segment with a small perforation was stented with a drug-eluting stent (DES), which might have resulted in the shifting of the fatty plaque toward the perforation and subsequently sealing the coronary perforation.

摘要

我们报告了1例极其罕见的病例，在左前降支冠状动脉次全闭塞血管重建过程中，1级冠状动脉穿孔通过“雪犁现象”自发闭合。冠状动脉穿孔通常是心脏导管室冠状动脉介入治疗中的噩梦。大的冠状动脉穿孔需要置入覆膜支架，小穿孔则需要逆转肝素、延长球囊扩张时间、置入小弹簧圈或使用明胶海绵封堵。发生小穿孔的冠状动脉节段植入了药物洗脱支架（DES），这可能导致脂肪斑块向穿孔处移动，随后封闭了冠状动脉穿孔。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b3f/10962301/6b7c59cb4cba/cureus-0016-00000054818-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b3f/10962301/3910bf15c980/cureus-0016-00000054818-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b3f/10962301/dec8709eb213/cureus-0016-00000054818-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b3f/10962301/526ef3b06800/cureus-0016-00000054818-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b3f/10962301/8b487f53fa9d/cureus-0016-00000054818-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b3f/10962301/6b7c59cb4cba/cureus-0016-00000054818-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b3f/10962301/3910bf15c980/cureus-0016-00000054818-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b3f/10962301/dec8709eb213/cureus-0016-00000054818-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b3f/10962301/526ef3b06800/cureus-0016-00000054818-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b3f/10962301/8b487f53fa9d/cureus-0016-00000054818-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b3f/10962301/6b7c59cb4cba/cureus-0016-00000054818-i05.jpg

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本文引用的文献

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Successful Sealing of Elli's Type 3 Coronary Artery Perforation with Cyanoacrylate Glue.使用氰基丙烯酸酯胶水成功封堵埃利氏3型冠状动脉穿孔
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Successful closure of coronary artery perforation using non-conventional embolic material.使用非常规栓塞材料成功闭合冠状动脉穿孔。
Indian Heart J. 2005 Mar-Apr;57(2):170-1.
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Coronary vessel perforation during balloon angioplasty: a case report.球囊血管成形术期间冠状动脉穿孔：一例报告
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