作为栓塞材料的亲水性聚合物涂层碎片--罕见并发症和潜在死因

Slezak, Bloch-Bogusławska, Grzanka
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摘要

经皮冠状动脉介入治疗和其他血管内手术最常见的并发症包括插入部位的轻微出血、血肿或感染[1]。更严重的并发症包括血管壁损伤、夹层、造影剂引起的休克、急性肾损伤、心肌梗死[2]和缺血性中风[3]。缺血性并发症可由血栓形成或动脉粥样硬化斑块碎片脱落导致的栓塞事件引起[3]。一种很少诊断的并发症是由插入血管的设备外层材料--亲水性聚合物涂层(HPC)--产生的微栓子引起的缺血[4]。我们介绍了一个有趣的病例,即在比得哥什法医部进行的法医尸检(L.dz. 676/19)中,在心肌制备物中的冠状血管中发现了 HPC。本文提出了临床影响和法医方面的问题。
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Fragments of hydrophilic polymer coating as an embolic material – rare complication and potential cause of death
The most common complications of percutaneous coronary interventions and other endovascular procedures include minor hemorrhage, hematoma, or infection at the insertion site [1]. Much more serious ones include damage to the vessel wall, dissection, shock from contrast administration, acute kidney injury, myocardial infarction [2] and ischemic stroke [3]. Ischemic complications can be caused by an embolic incident due to a thrombus formation or detachment of atherosclerotic plaque fragments [3]. A rarely diagnosed complication is ischemia caused by microembolisms from the material covering the equipment inserted into the vessel – hydrophilic polymer coating (HPC)[4]. We present an interesting case of HPC revealed in coronary vessels within myocardial preparations taken in forensic post-mortem examination conducted at the Department of Forensic Medicine in Bydgoszcz (L.dz. 676/19). This article raises the issue of clinical implications and forensic aspects.
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