用于治疗限制血流的冠状动脉壁内血肿的 "切割(切割-点蚀球囊)技术"。

IF 2.1 3区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Catheterization and Cardiovascular Interventions Pub Date : 2024-11-01 Epub Date: 2024-09-26 DOI:10.1002/ccd.31231
Gabriele Luigi Gasparini, Matteo Maurina, Damiano Regazzoli, Paolo Canova, Pier Pasquale Leone, Antonio Mangieri, Bernhard Reimers
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引用次数: 0

摘要

背景:冠状动脉断裂是由于血管内皮撕裂,导致血液外渗进入内膜下间隙,继而产生壁内血肿(IMH)。处理这种并发症的一种潜在技术是使用切割球囊,但有相当多的病例出现血肿向远端扩散的情况。我们介绍了一种新技术,它能提高在假腔和真腔之间形成内膜撕裂的可能性,有助于血肿引流和恢复远端冠状动脉血流:我们对接受经皮冠状动脉介入治疗并发血流受限的壁内血肿的七名连续患者进行了回顾性分析。根据操作者的偏好,所有患者均采用 "切割技术 "进行治疗。手术成功的定义是达到心肌梗死远端溶栓3级(TIMI 3)血流:结果:在采用 "切割技术 "治疗的七名患者中,有五名患者的血流完全恢复到 TIMI 3:结论:我们的病例表明,"切割技术 "是治疗 IMH 的一种可行方法。该技术提高了在假腔和真腔之间形成内膜撕裂的可能性,有助于血肿引流和恢复远端冠状动脉血流。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The "Cuttering (Cutting-Dottering Balloon) Technique" for treatment of flow-limiting coronary intramural hematoma.

Background: Coronary artery dissections are caused by a tear in the vessel endothelium, resulting in blood extravasation into the subintimal space, with subsequent intramural hematoma (IMH). One potential technique to deal with this complication is the use of cutting balloons, however, a significant number of cases experienced distal propagation of the hematoma. We describe a novel technique that enhances the possibility of creating intimal tears between the false and true lumen, aiding in hematoma drainage and restoring distal coronary flow.

Methods: We conducted a retrospective analysis of seven consecutive patients who underwent percutaneous coronary intervention complicated by flow-limiting intramural hematomas. All patients were treated using the "Cuttering Technique," based on the operators' preference. Procedural success was defined as achieving a distal thrombolysis in myocardial infarction 3 (TIMI 3) flow.

Results: In five out of seven patients treated with "Cuttering Technique" we observed a complete restoration of TIMI 3 flow into the dissected segment.

Conclusions: Our cases show the effectiveness of the "Cuttering Technique" as a viable approach for managing IMHs. This technique enhances the possibility of creating intimal tears between the false and true lumens, aiding in hematoma drainage and restoring distal coronary flow.

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来源期刊
CiteScore
5.40
自引率
8.70%
发文量
419
审稿时长
2 months
期刊介绍: Catheterization and Cardiovascular Interventions is an international journal covering the broad field of cardiovascular diseases. Subject material includes basic and clinical information that is derived from or related to invasive and interventional coronary or peripheral vascular techniques. The journal focuses on material that will be of immediate practical value to physicians providing patient care in the clinical laboratory setting. To accomplish this, the journal publishes Preliminary Reports and Work In Progress articles that complement the traditional Original Studies, Case Reports, and Comprehensive Reviews. Perspective and insight concerning controversial subjects and evolving technologies are provided regularly through Editorial Commentaries furnished by members of the Editorial Board and other experts. Articles are subject to double-blind peer review and complete editorial evaluation prior to any decision regarding acceptability.
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