Séniors et lésions coronaires calcifiées

IF 0.3 Q4 Medicine

Annales de cardiologie et d'angeiologie Pub Date : 2025-08-20 DOI:10.1016/j.ancard.2025.101926

Ikram El marzouki , Jacques Monsegu

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引用次数: 0

Abstract

Coronary artery calcification is highly prevalent in elderly patients and poses significant challenges during percutaneous coronary intervention (PCI).

We report the case of an 86-year-old man admitted for ST-elevation myocardial infarction. Coronary angiography revealed triple-vessel disease with an acute coronary artery occlusion, a long, heavily calcified proximal-to-mid left anterior descending artery stenosis, and a severely calcified proximal circumflex lesion. PCI revascularization was performed in 3 steps: primary PCI of the right coronary artery initially, then 3 days after, PCI of the circumflex artery using rotational atherectomy, scoring balloon dilation, and intravascular lithotripsy. Then, at Day 15, PCI of the left anterior descending artery with orbital atherectomy finished complete revascularization.

This case underscores the importance of a comprehensive geriatric assessment—particularly frailty and physiological age—before selecting a revascularization strategy requiring the use of specific tools as advanced plaque-modification techniques and intravascular imaging, without any restriction according to age.

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老年和冠状动脉钙化损伤

冠状动脉钙化在老年患者中非常普遍，对经皮冠状动脉介入治疗（PCI）提出了重大挑战。我们报告的情况下，86岁的男子承认st段抬高心肌梗死。冠状动脉造影显示三支血管病变，包括急性冠状动脉闭塞，左前降支近端至中端长且严重钙化狭窄，以及严重钙化的近端旋支病变。PCI血运重建术分3步进行：最初对右冠状动脉进行初级PCI，然后在3天后，采用旋转动脉粥样硬化切除术、记分球囊扩张和血管内碎石对旋支动脉进行PCI。然后，在第15天，左前降支PCI并眼眶动脉粥样硬化切除术完成完全血运重建。该病例强调了全面的老年评估的重要性，特别是虚弱和生理年龄，在选择血管重建策略之前，需要使用特定的工具，如先进的斑块修饰技术和血管内成像，而不受年龄的限制。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annales de cardiologie et d'angeiologie 医学-外周血管病

CiteScore

0.60

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Organe scientifique de référence fondé en 1951, les Annales de cardiologie et d''angéiologie abordent tous les domaines qui intéressent quotidiennement les cardiologues et les angéiologues praticiens : neurologie et radiologie vasculaires, hémostase, diabétologie, médecine interne, épidémiologie et prévention. Les Annales de cardiologie et d''angéiologie sont indexées aux grandes bases de données et publient rapidement, et en conformité avec les normes internationales de publication scientifique, des articles en français sur la pathologie cardiaque.