PDF(Pubmed)
Abstract：
Takayasu\'s arteritis (TAK) is a rare chronic granulomatous arteritis that mainly affects the aorta and its major branches. Coronary artery (CA) involvement can be observed in 10-25% of TAK patients. We report a 21-year-old young female who was previously diagnosed with TAK and severe left main coronary artery (LMCA) stenosis and underwent numerous percutaneous coronary interventions (PCIs) in our hospital due to in-stent restenosis (ISR). This time, an excimer laser coronary atherectomy (ELCA) and drug-coated balloon (DCB) dilation was taken at the LMCA for the ISR. The blood flow was smooth after the operation, and she was symptom-free after discharge. Unfortunately, 5 months later, severe intimal hyperplasia was still seen in the stent of LMCA and left anterior descending (LAD) coronary artery. A coronary artery bypass graft surgery (CABG) was performed, and she has been symptom-free ever since. ELCA plus DCB is one of the novel ways we first reported. However, ensuring long-term inflammation control is equally important to restore blood flow. The combination of revascularization and anti-inflammation/immunosuppression is recommended to improve the outcomes of TAK patients with CA involvements.
摘要：
Takayasu动脉炎（TAK）是一种罕见的慢性肉芽肿性动脉炎，主要影响主动脉及其主要分支。在10-25％的TAK患者中可以观察到冠状动脉（CA）受累。我们报告了一名21岁的年轻女性，她先前被诊断出患有TAK和严重的左主干冠状动脉（LMCA）狭窄，并且由于支架内再狭窄（ISR）在我们医院接受了多次经皮冠状动脉介入治疗（PCI）。这一次,在LMCA对ISR进行了准分子激光冠状动脉粥样斑块切除术(ELCA)和药物涂层球囊扩张术(DCB).手术后血流顺畅,出院后没有症状.不幸的是,5个月后,在LMCA支架和左前降支（LAD）冠状动脉中仍可见严重的内膜增生。进行了冠状动脉旁路移植手术（CABG），从那以后她就没有症状了.ELCA加DCB是我们最早报导的新办法之一。然而,确保长期控制炎症对恢复血流同样重要。建议将血运重建和抗炎/免疫抑制相结合，以改善TAK患者CA受累的预后。
