An Unusual Case of Long-Segment Dissection of the Left Anterior Descending Coronary Artery During Osteoproximal Chronic Total Occlusion Intervention.

在近端骨慢性完全闭塞介入治疗期间 ， 左前下降冠状动脉长段夹层的不寻常情况。

• 发表时间: 2023 Oct
• 来源期刊: Cureus
• DOI: 10.7759/cureus.46526
• PMID: 37927712
• 文章类型: Case Reports
• 作者列表: Mahanta D,Parhi DK,Gadade SV,Das D

关键词: chronic total occlusion; coronary artery; dissection; left anterior descending coronary artery; osteoproximal

Abstract

Coronary artery dissection can occur after post-balloon inflation; however, a very long-segment coronary dissection (>50 mm) is a rare occurrence during routine coronary interventions. Here, we report an extremely rare case of long-segment coronary dissection in the left anterior descending coronary artery (LAD) induced during antegrade revascularization of chronic total occlusion of osteoproximal LAD with stiffer Gaia II wire. The patient had excruciating angina with hemodynamic collapse and acute pulmonary edema; the patient was rescued with long-segment coronary revascularization.

摘要

冠状动脉夹层可在球囊扩张后发生；然而，在常规冠状动脉介入治疗期间,非常长的冠状动脉夹层(>50mm)很少发生.这里,我们报告了一例极为罕见的病例，在用较硬的GaiaII线对近端LAD慢性完全闭塞的顺行血运重建过程中引起的左前降支冠状动脉（LAD）的长段冠状动脉夹层。该患者患有剧烈的心绞痛，伴有血流动力学塌陷和急性肺水肿；该患者接受了长段冠状动脉血运重建术。