Hart Ilgizar, Silkowski Molly, Kendsersky Payton, Fernandes Valerian, Maran Anbukarasi
Division of Cardiology, Medical University of South Carolina, Charleston, South Carolina, USA.
Division of Cardiology, Medical University of South Carolina, Charleston, South Carolina, USA.
JACC Case Rep. 2025 May 28;30(12):103506. doi: 10.1016/j.jaccas.2025.103506.
During laser atherectomy, the use of contrast can lead to the formation of microbubbles, a common but potentially problematic occurrence. This can result in distal embolization and significant hemodynamic compromise. We would like to share a case of a 64-year-old female who had severe calcified in-stent restenosis with stent underexpansion, which was treated with excimer laser coronary atherectomy. The procedure was complicated by the formation of macrobubbles, which caused slow reflow with temporary hypotension and bradycardia. Laser atherectomy can cause macrobubble formation with distal embolization when using angiographic contrast. To minimize the risk of this complication, it may be reasonable to use more diluted contrast in such cases.
在激光斑块旋切术期间，使用造影剂可导致微气泡形成，这是一种常见但可能有问题的情况。这可能导致远端栓塞和严重的血流动力学损害。我们想分享一例64岁女性患者的病例，该患者患有严重的支架内钙化再狭窄且支架扩张不足，接受了准分子激光冠状动脉斑块旋切术治疗。该手术因大气泡形成而复杂化，导致缓慢血流恢复，并伴有暂时性低血压和心动过缓。当使用血管造影剂时，激光斑块旋切术可导致大气泡形成并伴有远端栓塞。为了将这种并发症的风险降至最低，在此类病例中使用稀释度更高的造影剂可能是合理的。
