背景:随着经皮冠状动脉介入治疗(PCI)的发展,没有植入的介入程序的数量,如生物可吸收支架(BRS)和药物涂层球囊,每年都在增加。金属药物洗脱支架卸载是临床最常见的并发症之一。相对而言,BRS分离更具隐蔽性和危害性,但尚未在临床研究中报道。在这项研究中,我们报告了一例BRS卸载和成功抢救的病例。
方法:这是一例59岁男性,有以下病史:“2型糖尿病”2年,用二甲双胍缓释片维持,1克POBID;“高血压”20年,长期使用美托洛尔缓释片,47.5毫克POQD;“高脂血症”20年,没有常规药物。他因持续18小时的间歇性胸痛被送进我院急诊科,2022年2月20日15:35心电图结果显示窦性心律,导线I和avL的ST段抬高,V1-3导联的R波进展不佳。高敏肌钙蛋白I水平为4.59ng/mL,提示急性高侧壁心肌梗死。患者家属要求BRS治疗,没有植入。在PCI期间,BRS被卸载,但被成功救出。患者随访2年;他没有心绞痛发作,总体状况良好。
结论:我们描述了一例59岁男性经历BRS卸载和成功抢救的病例。通过分析图像,讨论了BRS卸载的原因和处理方案,为BRS释放操作提供见解。我们讨论了BRS卸载的预防措施。
BACKGROUND: With the development of percutaneous coronary intervention (PCI), the number of interventional procedures without implantation, such as bioresorbable stents (BRS) and drug-coated balloons, has increased annually. Metal drug-eluting stent unloading is one of the most common clinical complications. Comparatively, BRS detachment is more concealed and harmful, but has yet to be reported in clinical research. In this study, we report a
case of BRS unloading and successful rescue.
METHODS: This is a
case of a 59-year-old male with the following medical history: \"Type 2 diabetes mellitus\" for 2 years, maintained with metformin extended-release tablets, 1 g PO BID; \"hypertension\" for 20 years, with long-term use of metoprolol sustained-release tablets, 47.5 mg PO QD; \"hyperlipidemia\" for 20 years, without regular medication. He was admitted to the emergency department of our hospital due to intermittent chest pain lasting 18 hours, on February 20, 2022 at 15: 35. Electrocardiogram results showed sinus rhythm, ST-segment elevation in leads I and avL, and poor R-wave progression in leads V1-3. High-sensitivity troponin I level was 4.59 ng/mL, indicating an acute high lateral wall myocardial infarction. The patient\'s family requested treatment with BRS, without implantation. During PCI, the BRS became unloaded but was successfully rescued. The patient was followed up for 2 years; he had no episodes of angina pectoris and was in generally good condition.
CONCLUSIONS: We describe a
case of a 59-year-old male experienced BRS unloading and successful rescue. By analyzing images, the causes of BRS unloading and the treatment plan are discussed to provide insights for BRS release operations. We discuss preventive measures for BRS unloading.