右冠状动脉开口罕见巨大钙化斑块致严重狭窄病变介入治疗1例One case of coronary interventional treatment of severe stenosis caused by huge calcified plaque at the right coronary artery ostium
周力,化冰,马龙辉,梁拓,陈晖
摘要(Abstract):
冠状动脉严重钙化病变介入手术风险高、操作难度大,向来是令心脏介入医师感到棘手的难题。以腔内影像学为指导、冠状动脉斑块旋磨术为保障的治疗策略虽被共识所推荐,但在我国的应用比例仍然较低。本中心在旋磨术处理严重钙化病变方面积累了较多经验,尤其在左主干病变、开口病变以及迂曲成角病变等复杂场景下的应用。本文报道1例位于右冠状动脉开口的巨大钙化斑块致偏心性严重狭窄病变的介入治疗,讨论血管内超声指导旋磨术进行斑块修饰及部分消蚀的方法及策略。
关键词(KeyWords): 旋磨术;钙化斑块;经皮冠状动脉介入治疗
基金项目(Foundation): 北京市自然科学基金项目(L232116)
作者(Author): 周力,化冰,马龙辉,梁拓,陈晖
参考文献(References):
- [1] Florek K, Bartoszewska E, Biega?a S, et al. Rotational atherectomy, orbital atherectomy, and intravascular lithotripsy comparison for calcified coronary lesions[J]. J Clin Med,2023,12(23):7246. DOI:10.3390/jcm12237246.
- [2] Vera-Vera S, Garcia A, Jimenez-Valero S, et al. Excimer laser coronary atherectomy to treat calcified lesions[J]. Interv Cardiol,2022,17:e14. DOI:10.15420/icr.2022.10.
- [3]《冠状动脉钙化病变诊治中国专家共识》专家组.冠状动脉钙化病变诊治中国专家共识(2021版)[J].中国介入心脏病学杂志,2021, 29(5):251-259. DOI:10.3969/j.issn.1004-8812.2021.05.002.
- [4]葛均波,王伟民,霍勇.冠状动脉内旋磨术中国专家共识[J].中国介入心脏病学杂志,2017, 25(2):61-66.DOI:10.3969/j.issn.1004-8812. 2017.02.001.
- [5]血管内超声在冠状动脉疾病中应用的中国专家共识专家组.血管内超声在冠状动脉疾病中应用的中国专家共识(2018)[J].中华心血管病杂志,2018,46(5):344-351. DOI:10.3760/cma.j.issn.0253-3758.2018. 05.005.
- [6] Sakakura K, Taniguchi Y, Yamamoto K, et al. Association of excessive speed reduction with clinical factors during rotational atherectomy[J]. Cardiovasc Revasc Med,2020,21(3):314-319. DOI:10.1016/j.carrev.2019.05.014.
- [7] Sakakura K, Ito Y, Shibata Y, et al. Clinical expert consensus document on rotational atherectomy from the Japanese association of cardiovascular intervention and therapeutics:update 2023[J]. Cardiovasc Interv Ther,2023,38(2):141-162.DOI:10.1007/s12928-022-00906-7.