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外周锚定:一种处理冠状动脉支架移位的补救策略

Peripheral Parking: A Bailout Strategy for Managing Dislodged Coronary Stents.

作者信息

Padhiary Satyajit, Kumar Devesh, Arya Anbhigya Kumar, Khan Maaz Ahmad, Singh Saurabh Kumar

机构信息

Cardiology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, IND.

出版信息

Cureus. 2025 Jul 25;17(7):e88757. doi: 10.7759/cureus.88757. eCollection 2025 Jul.

Abstract

Coronary stent dislodgement is a rare but potentially life-threatening complication during percutaneous coronary intervention (PCI). It may occur due to complex anatomy, heavy calcification, tortuous vessels, or equipment malfunction, leading to embolization, vessel injury, or myocardial infarction if not promptly addressed. We present a case of stent dislodgement during transradial PCI, wherein a dislodged undeployed coronary stent migrated to the peripheral arterial system (left common iliac artery) seen on non-contrast computed tomography (NCCT). On subsequent fluoroscopy, the stent was seen aligned with the vessel contour and with good flow across it, so parked permanently without compromising distal flow or limb perfusion. The patient remained hemodynamically stable, and no short-term vascular complications were observed. This case highlights the peripheral parking technique as a practical bailout strategy in scenarios where retrieval is not feasible and the stent is inaccessible or poses a risk of further embolization.

摘要

冠状动脉支架移位是经皮冠状动脉介入治疗(PCI)期间一种罕见但可能危及生命的并发症。它可能由于解剖结构复杂、严重钙化、血管迂曲或设备故障而发生,如果不及时处理,会导致栓塞、血管损伤或心肌梗死。我们报告一例经桡动脉PCI期间发生支架移位的病例,其中一个未展开的移位冠状动脉支架迁移至外周动脉系统(左髂总动脉),这在非增强计算机断层扫描(NCCT)上可见。在随后的荧光透视检查中,可见支架与血管轮廓对齐且血流良好,因此永久性放置,未影响远端血流或肢体灌注。患者血流动力学保持稳定,未观察到短期血管并发症。该病例突出了外周放置技术作为一种实用的补救策略,适用于无法进行取回操作且支架无法触及或有进一步栓塞风险的情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d56b/12375392/2cd54450bcb7/cureus-0017-00000088757-i01.jpg

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