Excimer laser coronary atherectomy and balloon dilation in the treatment of severe calcified coronary artery stenosis: a case report
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摘要: 69岁女性患者因胸痛7 h入院。既往有高血压和胆囊结石病史。半年前因急性下后壁心肌梗死，于右冠状动脉植入支架2枚，前降支因钙化严重拟择期处理。此次入院诊断为不稳定性心绞痛，在体外肺膜氧合系统辅助下行复杂高危经皮冠状动脉介入治疗。由于前降支钙化严重，导丝进入较困难，球囊难以通过，故使用准分子激光斑块消蚀术进行预处理。反复在血液稀释对比剂下行斑块消融，激光与球囊扩张交替进行，直至扩开病变，成功于前降支及对角支植入4枚支架。术后病情好转出院。6个月随访血管通畅。
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关键词:
- 经皮冠状动脉介入治疗 /
- 准分子激光冠状动脉斑块消蚀术 /
- 冠状动脉斑块旋磨术 /
- 冠状动脉钙化病变
Abstract: A 69-year-old female patient was admitted to hospital with chest pain for 7 hours. She has a history of hypertension and gallstones. Six months ago, due to acute inferior posterior myocardial infarction, two stents were implanted in the right coronary artery, and the anterior descending branch was scheduled for elective treatment due to serious calcification. The diagnosis was unstable angina pectoris and complex high-risk percutaneous coronary intervention assisted by extracorporeal membrane oxygenation was performed. Due to the severe calcification of the anterior descending branch, it is difficult for the guide wire to enter and the balloon to pass through, so excimer laser coronary atherectomy (ELCA) was used for pretreatment. ELCA was performed repeatedly under hemodilution contrast agent, and ELCA and balloon dilation were performed alternately until the lesions were expanded, and 4 stents were successfully implanted in the anterior descending branch and diagonal branch. After active treatment, the patient's condition improved and was discharged. Vascular patency was observed at 6 months. -
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