Misumi T, Nishikawa K, Gotoh T, Chino M, Yamane M
Department of Cardiovascular Surgery, Ashikaga Red Cross Hospital, Tochigi, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1995 Jun;43(6):875-8.
We presented a case of a 48-year-old male with failed delivery of the Palmaz-Schatz stent, who subsequently required CABG with successful retrieval of the stent. The patient had presented recurrent angina, approximately one and a half year since the last PTCA to the LAD. Re-PTCA was performed, but resulted in a severe local dissection. The stent implantation was tried, but was inadvertently dropped in the vessel. Since the patient was hemodynamically stable, we tried to remove the stent with Retriever endovascular snare, which ended up with interlocking the stent in the more proximal segment of the LAD and the snare itself was not removed. We, therefore, resort to the emergent operation, with successful retrieval of the snare device and the stent and carried on to the the bypass operation to the distal LAD without any complications. To our best knowledge, this is the first report in Japan for surgical retrieval of the Palmaz-Schatz stent, which was failed in delivery and interlocked in the vessel with retriever device.
我们报告了一例48岁男性患者，其Palmaz-Schatz支架植入失败，随后需要进行冠状动脉搭桥术（CABG）并成功取出支架。该患者自上次对左前降支（LAD）进行经皮冠状动脉腔内血管成形术（PTCA）约一年半后出现复发性心绞痛。再次进行PTCA，但导致严重的局部夹层。尝试植入支架，但支架不慎掉入血管内。由于患者血流动力学稳定，我们尝试使用Retriever血管内圈套器取出支架，结果支架在LAD更近端的节段发生联锁，圈套器本身未能取出。因此，我们采取了紧急手术，成功取出了圈套器和支架，并继续对LAD远端进行搭桥手术，未出现任何并发症。据我们所知，这是日本首例关于手术取出未能成功植入且与圈套器在血管内联锁的Palmaz-Schatz支架的报告。
