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頁籤選單縮合
題名 | "Inter-lacing" of Stents: 13-Month Follow-up by Intravascular Ultrasound after Primary Simultaneous Kissing Stenting=採用雙槍式血管內支架置放之緊急血管成型術--13個月後血管內超音波追蹤:『相嵌的支架』 |
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作者 | 辛和宗; 邱昱偉; 廖朝崧; 朱樹勳; | 書刊名 | Acta Cardiologica Sinica |
卷期 | 23:4 2007.12[民96.12] |
頁次 | 頁277-281 |
分類號 | 415.3161 |
關鍵詞 | 雙槍式血管內支架置放; 血管內超音波; 冠狀動脈; 分叉病灶; Kissing stent; IVUS; Coronary artery; Bifurcation; |
語文 | 英文(English) |
中文摘要 | 一位54歲男性因為許壁急性ST節段上昇型必肌梗塞接受緊急血管成型術,但心肌梗塞相關之左前降枝呈現Duke type D之分叉型病灶,更頭痛的是中段左前降枝病灶前後段之血管內徑差異極大,其Diagonal 2又極為粗大,造成傳統分叉病灶支架置放方式如culotte-or T-stenting無法順利執行。於此案例吾人成功的使用simultaneous kissing stenting(雙槍式血管內支架置放),順利的完成心肌梗塞血管的成型術。並淤13個月後以血管內超音波追蹤,發現無明顯的支架內再狹窄,並且兩支支架雙重主幹(double-barrel)的部分呈現完整兩個圓形截面而且有部分相嵌(inter-lacing)的情形,完全不同於傳統預想的『背靠背』的兩個圓形。 |
英文摘要 | A fifty-four-year old man suffered from ST-segment elevation myocardial infarction of Killip class Ⅰ over the anterior wall. The emergent coronary angiogram showed true bifurcation lesion of Duke type Dover the mid-LAD and 2(superscript nd) diagonal branch. The stealing strategy was made more difficult by discrepant diameters of the mid and distal LAD, which hampered cullote-or T-stenting technique. Simultaneous kissing stenting was successfully performed in the scenario of acute myocardial infarction. Angiographic follow-up showed minimal in-stent restenosis of both stents. Interestingly, the IVUS disclosed that the "double-barrel" portion at the stents had become inter-laced, not in the expected pattern of "back-to-back", The interesting picture could he explained by double-helix configuration of the double-barrel portion of the stems, and the innate inward driving-force originating from negative remodeling of the accommodating vessel, |
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