冠状动脉支架植入术后感染性动脉瘤的形成

K. Soomro
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引用次数: 1

摘要

冠状动脉动脉瘤(CAA)的形成是经皮冠状动脉介入治疗(PCI)后的重要并发症之一。动脉瘤扩张最常见的病因和加重因素是获得性的,如动脉粥样硬化、川崎病、Takayasu病、结缔组织病、经皮冠状动脉介入治疗(PCI)后创伤和感染。心导管插入术本身的菌血症风险可以忽略不计。我们提出的情况下,病人谁有感染性冠状动脉动脉瘤,PCI后发展。一名63岁男性患者1个月前患有ST-T心肌梗死,63年前在左前降支首次行PCI治疗LAD, 1个月前在左前降支中放置了1个Des支架,并出现了一个大动脉瘤,患者仅在3周内出现C/O高热,无症状,休息时心绞痛4天。在重复冠状动脉造影中被诊断为动脉瘤。血管内超声示真动脉瘤,直径约5.6 mm。我们将回顾文献,讨论感染性动脉瘤的病因,特别是在复发症状或作为常规血管造影随访的一部分进行重复血管造影时发现的支架动脉瘤的治疗选择[1]。
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Infectious Aneurysm Formation after Coronary Stent Implantation
The formation of coronary artery aneurysm (CAA) is one of the critical complications after percutaneous coronary intervention (PCI). The most common aetiologies and aggravating factors for aneurysmal dilatation are acquired, such as atherosclerosis, Kawasaki disease, Takayasu disease, connective tissue disease, trauma after percutaneous coronary intervention (PCI) and infections. Cardiac catheterization itself carries a negligible bacteremic risk. We present the case of a patient who had infective coronary artery aneurysms that developed after PCI. A 63 years old male who had ST-T MI 1 month back and underwent primary percutaneous coronary intervention with deployment of 1 Des stent in Mid left anterior polymer-based paclitaxel-eluting stent 63 years having primary PCI for LAD 1 month back in the left anterior descending artery and A large aneurysm developed MID DES. The patient had C/O high grade fever only since 3 weeks remained asymptomatic then had angina at rest for 4 days. An aneurysm was diagnosed at middle of DES on repeat coronary angiography. Intravascular ultrasound demonstrated a true aneurysm about 5.6 mm in diameter. We will review the literature and discuss the causes specially infectious aneurysm and treatment option of aneurysm with stent usually detected at the time of repeat angiography for recurrent symptoms or as apart of the routine angiographic follow up [1].
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