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经皮冠状动脉介入治疗后医源性A型主动脉夹层

Iatrogenic Type A Aortic Dissection Following Percutaneous Coronary Intervention.

作者信息

Abdul Manan Hafiz, Khan Muhammad, Rafiq Muhammad

机构信息

Cardiology, Darent Valley Hospital, Dartford, GBR.

Cardiology, Salisbury District Hospital, Salisbury, GBR.

出版信息

Cureus. 2024 Nov 17;16(11):e73884. doi: 10.7759/cureus.73884. eCollection 2024 Nov.

DOI:10.7759/cureus.73884
PMID:39697962
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11653049/
Abstract

Iatrogenic type A aortic dissection (IAAD) is a rare but life-threatening complication of percutaneous coronary intervention (PCI), often presenting significant therapeutic challenges. A looped guidewire between the right subclavian artery and brachiocephalic artery during coronary angiography (CAG) via right radial artery access can complicate catheter manipulation. This report discusses the case of a 58-year-old hypertensive female patient who developed aortic dissection during PCI, specifically due to wire manipulation at the brachiocephalic loop. The dissection extended retrogradely into the ascending aorta. Despite the severity, the patient remained hemodynamically stable and free from myocardial ischemia. Given her stability, conservative management focusing on blood pressure control was chosen. Serial CT imaging confirmed stabilization of the dissection. The patient underwent successful PCI via the femoral approach at a later date and was discharged the following day. This case underscores the potential for conservative management in select IAAD cases, emphasizing individualized treatment strategies.

摘要

医源性A型主动脉夹层（IAAD）是经皮冠状动脉介入治疗（PCI）罕见但危及生命的并发症，常带来重大治疗挑战。经右桡动脉途径进行冠状动脉造影（CAG）时，右锁骨下动脉和头臂动脉之间出现环形导丝会使导管操作复杂化。本报告讨论了一名58岁高血压女性患者在PCI期间发生主动脉夹层的病例，具体原因是在头臂环处进行导丝操作。夹层逆行延伸至升主动脉。尽管病情严重，但患者血流动力学保持稳定，未发生心肌缺血。鉴于其稳定性，选择了以控制血压为重点的保守治疗。系列CT成像证实夹层已稳定。该患者随后经股动脉途径成功进行了PCI，并于次日出院。本病例强调了在某些IAAD病例中进行保守治疗的可能性，强调了个体化治疗策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b2cb/11653049/18c9a3f6b0c3/cureus-0016-00000073884-i10.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b2cb/11653049/c263afb4ef35/cureus-0016-00000073884-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b2cb/11653049/9a536f2f6898/cureus-0016-00000073884-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b2cb/11653049/00d2dda700df/cureus-0016-00000073884-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b2cb/11653049/a0cf24e98723/cureus-0016-00000073884-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b2cb/11653049/229bb1289965/cureus-0016-00000073884-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b2cb/11653049/291e7e622958/cureus-0016-00000073884-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b2cb/11653049/794e744fe5ea/cureus-0016-00000073884-i07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b2cb/11653049/c9067998b702/cureus-0016-00000073884-i08.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b2cb/11653049/8c3968c1c04f/cureus-0016-00000073884-i09.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b2cb/11653049/18c9a3f6b0c3/cureus-0016-00000073884-i10.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b2cb/11653049/c263afb4ef35/cureus-0016-00000073884-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b2cb/11653049/9a536f2f6898/cureus-0016-00000073884-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b2cb/11653049/00d2dda700df/cureus-0016-00000073884-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b2cb/11653049/a0cf24e98723/cureus-0016-00000073884-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b2cb/11653049/229bb1289965/cureus-0016-00000073884-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b2cb/11653049/291e7e622958/cureus-0016-00000073884-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b2cb/11653049/794e744fe5ea/cureus-0016-00000073884-i07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b2cb/11653049/c9067998b702/cureus-0016-00000073884-i08.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b2cb/11653049/8c3968c1c04f/cureus-0016-00000073884-i09.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b2cb/11653049/18c9a3f6b0c3/cureus-0016-00000073884-i10.jpg

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3
Aortic Dissection: A Review of the Pathophysiology, Management and Prospective Advances.
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Curr Cardiol Rev. 2021;17(4):e230421186875. doi: 10.2174/1573403X16666201014142930.
4
Iatrogenic aortic dissection during percutaneous coronary intervention: A case report and review of the literature.经皮冠状动脉介入治疗期间发生的医源性主动脉夹层：一例病例报告及文献复习
J Int Med Res. 2018 Jan;46(1):526-532. doi: 10.1177/0300060517716342. Epub 2017 Jul 6.
5
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6
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7
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8
[Acute aortic syndrome].[急性主动脉综合征]
Med Klin Intensivmed Notfmed. 2014 Jun;109(5):371-84. doi: 10.1007/s00063-014-0391-y.
9
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Ann Vasc Dis. 2012;5(1):78-81. doi: 10.3400/avd.cr.11.00057. Epub 2012 Jan 31.
10
Acute aortic dissection type A.急性 A 型主动脉夹层。
Br J Surg. 2012 Oct;99(10):1331-44. doi: 10.1002/bjs.8840.