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等待肝移植的终末期肝病患者经皮冠状动脉支架置入术成功

Successful Percutaneous Coronary Stenting in End-Stage Liver Disease Patients Awaiting Liver Transplantation.

作者信息

Raza Anoshia, Lim Philip, Shah Kajol, Sudyn Alexander, Gerula Christine, Waller Alfonso H, Gardin Julius M, Klapholz Marc

机构信息

Cardiology, Newark Beth Israel Medical Center, Newark, USA.

Medicine, Rutgers University New Jersey Medical School, Newark, USA.

出版信息

Cureus. 2024 Dec 28;16(12):e76520. doi: 10.7759/cureus.76520. eCollection 2024 Dec.

Abstract

Coronary artery disease (CAD) is associated with poor outcomes after orthotopic liver transplantation (OLT). We report on six high-risk end-stage liver disease (ESLD) patients who underwent percutaneous coronary intervention (PCI) with bare metal stents during the preoperative evaluation process. There was no mortality or major adverse cardiac event (MACE) within 90 days of OLT. These patients had advanced models for end-stage liver disease sodium (MELD-Na) scores (mean 24.5), thrombocytopenia (mean 70,500 µL⁻¹), and elevated international normalized ratio (INR; mean 2.0), who tolerated stent implantation followed by modified antiplatelet regimens. Percutaneous coronary intervention may facilitate listing with good OLT outcomes.

摘要

冠状动脉疾病(CAD)与原位肝移植(OLT)后的不良预后相关。我们报告了6例终末期肝病(ESLD)高危患者,他们在术前评估过程中接受了裸金属支架经皮冠状动脉介入治疗(PCI)。OLT术后90天内无死亡或重大不良心脏事件(MACE)发生。这些患者终末期肝病钠模型(MELD-Na)评分较高(平均24.5),存在血小板减少(平均70,500 μL⁻¹)和国际标准化比值(INR)升高(平均2.0),他们耐受了支架植入及改良抗血小板方案。经皮冠状动脉介入治疗可能有助于患者列入移植名单并获得良好的OLT预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1499/11771528/5b5676a791ec/cureus-0016-00000076520-i01.jpg

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