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頁籤選單縮合
題名 | Successful Retrieval of Dislodged Paclitaxel-eluting Stent with a Nitinol Loop Snare: A Case Report=以鎳質環狀套圈成功取出脫落於冠狀動脈內藥物塗層支架之經驗--病例報告 |
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作者姓名(中文) | 朱志生; 李碩粲; 李坤泰; 林宗憲; 林見財; 溫文才; 許勝雄; 賴文德; | 書刊名 | The Kaohsiung Journal of Medical Sciences |
卷期 | 21:12 民94.12 |
頁次 | 頁566-570 |
分類號 | 415.384 |
關鍵詞 | 冠狀動脈整型術; 支架脫落; 併發症; 鎳質環狀套圈; Coronary angioplasty; Dislodged stent; Complication; Loop snare; |
語文 | 英文(English) |
中文摘要 | 在介入性心導管治療時,發生冠狀動脈支架脫落或栓塞的情況,雖然並不常見,但是一旦發生的時候,經常都是極為棘手的問題。在冠狀動脈裡發生支架脫落與栓塞,可能會造成血栓阻塞甚至引起心肌梗塞,若是在操作過程中使得支架掉落到周邊大血管,最糟糕莫過於發生嚴重的腦血管阻塞。雖然過去針對單純金屬支架在冠狀動脈血管內脫落後,有零星的病例與文獻報告討論如何以經皮介入性治療的方式取出,但是沒有文獻報導過藥物塗層支架脫落的案例。萬一這些介入性治療的嘗試都失敗,還是要考慮以外科開刀取出的可能性。本文報告一位病患在接受藥物塗層支架治療時,支架在右冠狀動脈近端脫落,最後有驚無險的以鎳質金屬套圈將其取出,並成功完成右冠狀動脈中段狹窄病灶的支架置放。隨著藥物塗層支架的發展與治療優點,冠狀動脈支架的使用有越來越多的趨勢,從事介入性心導管治療之醫師,必須對於此併發症的處置了然於心。 |
英文摘要 | Coronary stent dislodgment or embolization before deployment is a rare but challenging complication in interventional cardiology. Intracoronary embolization of the dislodged stent is associated with a high risk of coronary occlusion, due to thrombus formation and subsequent myocardial infarction. Furthermore, systemic embolization may cause severe cerebrovascular events. Nonsurgical retrieval strategies for this complication have been suggested, but bailout cardiac surgery may be indicated if percutaneous retrieval attempts fail. To our knowledge, this is the first case report of intracoronary drug-eluting stent dislodgment, and successful retrieval was accomplished by a loop snare technique. With the increasing trend of using drug-eluting stents in percutaneous coronary intervention, the likelihood of stent dislodgment or embolization may increase. It should be kept in mind, especially by coronary interventionists, how to manage this complication. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。