[1]李宗庄,张陈匀,岳 峰,等.桡动脉途径冠状动脉介入治疗中支架变形或脱载的原因及处理 [J].介入放射学杂志,2019,28(06):521-524.
 LI Zongzhuang,ZHANG Chenyun,YUE Feng,et al.Stent deformation or dislodgement occurring during coronary intervention therapy via radial artery approach: its causes and treatment[J].journal interventional radiology,2019,28(06):521-524.
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桡动脉途径冠状动脉介入治疗中支架变形或脱载的原因及处理



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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
28
期数:
2019年06期
页码:
521-524
栏目:
心脏介入
出版日期:
2019-06-25

文章信息/Info

Title:
Stent deformation or dislodgement occurring during coronary intervention therapy via radial artery approach: its causes and treatment
作者:
李宗庄 张陈匀 岳 峰 韦 方 刘志琴 田 野 谭洪文 吴 强
Author(s):
 LI Zongzhuang ZHANG Chenyun YUE Feng WEI Fang LIU Zhiqin TIAN Ye TAN Hongwen WU Qiang.
Department of Cardiology, Guizhou Provincial People’s Hospital, Guiyang, Guizhou Province 550002, China
关键词:
【关键词】 经皮冠状动脉介入治疗 支架变形 支架脱载 肱动脉 腋动脉
文献标志码:
A
摘要:
【摘要】 目的 分析贵州省人民医院经桡动脉行经皮冠状动脉介入治疗(PCI)过程中发生支架变形或脱载的原因及处理措施。方法 收集2005年1月至2018年5月所有经桡动脉行PCI患者,调取发生支架变形或脱载病例影像学资料,2名有经验的PCI医师根据影像学资料、病历资料及术者叙述,分析发生支架变形或脱载的主要原因及处理措施。结果 共入选经桡动脉PCI患者11 132例,发生支架变形或脱载10例,发生率0.90‰。支架变形或脱载原因(可能多原因并存):血管迂曲、成角和钙化(8例),导引导管与冠状动脉同轴性差(4例),深吸气导致支架异位释放后“逃逸”(1例),支架通过已释放支架侧孔时剐蹭(1例)。处理措施:冠状动脉内支架挤压(1例),冠状动脉内原位释放(1例),桡动脉释放(2例),经皮小切口血管钳夹取脱载至桡动脉穿刺口支架(1例),对侧桡动脉圈套器降主动脉抓捕(1例),同侧锁骨下动脉圈套器抓捕脱载“逃逸”支架(1例),同侧腋/肱动脉圈套器抓捕(3例)。结论 支架变形或脱载是经桡动脉PCI少见并发症,血管迂曲、成角、钙化及导管同轴性差是主要原因。处理措施应根据实际情况灵活掌握,回撤至腋/肱动脉圈套器捕获是简便、安全的选择。

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备注/Memo

备注/Memo:
(收稿日期:2018-11-07)
(本文编辑:边 佶)
更新日期/Last Update: 2019-06-11