Bartorelli Antonio L, Di Lenarda Francesca, Mantica Massimo, De Sanctis Valerio, Grancini Luca, Monizzi Giovanni, Mastrangelo Angelo, Mallia Vincenzo, Fabbiocchi Franco, Terzi Riccardo, Andreini Daniele
IRCCS Ospedale Galeazzi-Sant'Ambrogio, Via Cristina Belgioioso 173, 20157 Milan, Italy.
Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy.
Eur Heart J Suppl. 2025 Apr 16;27(Suppl 3):iii13-iii18. doi: 10.1093/eurheartjsupp/suaf008. eCollection 2025 Mar.
Pulmonary vein stenosis (PVS) has been recognized as a clinical entity complicating radiofrequency or cryoenergy ablation for atrial fibrillation. Although reduced by technical and procedural advancements, this complication portends remarkable morbidity and presents insidiously with non-specific symptoms causing frequent misdiagnosis and wrong management that lead to detection delay and major adverse implications. Non-invasive imaging is key for timely diagnosis and transcatheter procedural planning. Most recent consensus on severe and symptomatic PVS management indicates that stenting is the preferred treatment because of superior long-term patency compared to balloon angioplasty, particularly in patients with larger reference vessel diameter. However, the rate of recurrent stent restenosis is high and remains a great challenge. Goal of our manuscript is to provide a comprehensive review regarding pathophysiology, detection, treatment, and prevention of this serious iatrogenic complication.
肺静脉狭窄（PVS）已被公认为是一种使房颤射频或冷冻消融术变得复杂的临床病症。尽管技术和操作的进步已减少了这种并发症，但它仍预示着显著的发病率，且以非特异性症状隐匿出现，常导致误诊和错误治疗，进而造成诊断延迟及严重不良后果。无创成像对于及时诊断和经导管操作规划至关重要。关于重度和有症状的PVS管理的最新共识表明，由于与球囊血管成形术相比具有更优的长期通畅性，尤其是在参考血管直径较大的患者中，支架置入是首选治疗方法。然而，支架再狭窄的复发率很高，仍然是一个巨大的挑战。我们撰写本文的目的是对这种严重医源性并发症的病理生理学、检测、治疗及预防进行全面综述。
