血管内碎石术成功用于隐静脉移植血管急性支架扩张不全
Successful Intravascular Lithotripsy Use for Acute Stent Underexpansion in Saphenous Vein Grafts.
作者信息
Roy Sumon, Bakhshi Hooman, Wagle Anjali, Lawson Barbara, Miller Julie, Resar Jon, Johnston Peter V
机构信息
Department of Medicine, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Pauley Heart Center, Department of Cardiology, Virginia Commonwealth University, Richmond, Virginia.
出版信息
J Soc Cardiovasc Angiogr Interv. 2023 Nov 27;3(2):101248. doi: 10.1016/j.jscai.2023.101248. eCollection 2024 Feb.
Experience with intravascular lithotripsy (IVL) following stent deployment in saphenous vein graft (SVG) lesions is limited. We present 2 cases of percutaneous intervention in SVG in which acute stent underexpansion was successfully managed with IVL. In the first case, recalcitrant plaque required prestent deployment IVL, with intracoronary imaging showing persistent calcification. Additional poststent deployment IVL facilitated full expansion and successful stent delivery. In the second case, predilation with semicompliant balloons appeared angiographically effective, but stent deployment showed acute underexpansion. Postdilation with noncompliant balloons and ultimately IVL allowed full expansion and successful stent delivery. These are the first reported cases of IVL use immediately after stent deployment in SVG to treat underexpansion due to recalcitrant calcification.
在大隐静脉旁路移植血管（SVG）病变中支架置入后进行血管内碎石术（IVL）的经验有限。我们介绍2例SVG经皮介入治疗的病例，其中急性支架扩张不全通过IVL成功处理。在第一例中，顽固性斑块需要在支架置入前进行IVL，冠状动脉内成像显示钙化持续存在。支架置入后额外的IVL促进了完全扩张并成功完成支架植入。在第二例中，使用半顺应性球囊进行预扩张在血管造影上似乎有效，但支架置入显示急性扩张不全。使用非顺应性球囊进行后扩张并最终采用IVL实现了完全扩张并成功完成支架植入。这些是首次报道的在SVG支架置入后立即使用IVL治疗因顽固性钙化导致的扩张不全的病例。
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