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題名 | Subacute Thrombosis after Stents Implantation in a Patient with Two Adjacent Coronary Artery Aneurysms=相鄰的二處冠狀動脈瘤在經過冠狀動脈支架置放術後造成的亞急性血栓阻塞 |
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作者 | 許碩麟; 謝宜璋; 溫明賢; | 書刊名 | 長庚醫學 |
卷期 | 26:4 2003.04[民92.04] |
頁次 | 頁277-282 |
分類號 | 415.3161 |
關鍵詞 | 冠狀動脈瘤; 冠狀動脈支架; 冠狀動脈血栓; 氣球擴張術; Coronary aneurysm; Stents; Coronary thrombosis; Angioplasty; |
語文 | 英文(English) |
中文摘要 | 冠狀動脈瘤是一種不常見的疾病。當它合併顯著的冠狀動脈阻塞或狹窄時,施行經皮冠狀動脈氣球擴張術並輔以移本物包被的冠狀動脈支架置放術通常可以達到良好的結果。若置放無移本物包被的冠狀動脈?架則可能會有發生血栓栓塞的潛在危險。我們報告了一個非穩定型心絞痛的病人,其二個相鄰的冠狀動脈瘤在接受了經皮冠狀動脈氣球擴張術並輔以無移本物包被的冠狀動脈?架置放術之後,前後二次分別在此二個不同的冠狀動脈瘤發生亞急性的冠狀動脈?架血栓阻塞,須重覆地施行冠狀動能氣球擴張術才得以使血管再度暢通。術後並繼續給予靜脈肝素注射成功地防止了支架內血栓的再形成。出院後病患仍繼續服用口服抗凝血劑以預防血栓的再發生。 |
英文摘要 | coronary artery aneurysm is an uncommon disease. When it is associated with significantly obstructive coronary artery disease, percutaneous transluminal coronary angioplasty with graft-coated stent implantation usually provides favorable results. Non-coated stents may have the potential risk of thromboembolism. We present a patient with unstable angina who received elective balloon angioplasty and non-coated stent implantations in two adjacent aneurysms. Two episodes of subacute stent thrombosis occurred subsequently at the two different aneurismal lesions respectively, which were resolved by repeat balloon angioplasty. Post-procedural intravenous heparin infusion is strongly suggested to prevent the development of stent thrombosis. Long-term oral warfarin is also suggested for prophylaxis of recurrent thromboembolic event. |
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