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目的探讨冠状动脉介入治疗(PCI)并发冠状动脉穿孔的临床特点和处理方法。方法对我院2004～2010年10例PCI并发冠状动脉穿孔患者的穿孔原因、造影影像特点、处理方法及结果进行回顾性分析。结果穿孔血管为前降支5例、回旋支3例、右冠状动脉2例,其中C型病变5例、B型病变4例、A型病变1例。球囊扩张或支架释放压力过大致血管撕裂3例、导丝穿出血管7例;4例并发心包填塞。6例行球囊长时间低压扩张压迫、4例行心包穿刺引流。无一例死亡,无Q波性心肌梗死及急诊冠状动脉搭桥者。结论冠状动脉穿孔是PCI少见并发症、但可导致严重临床后果,及时诊断、积极处理是减少恶性心脏事件的关键。
Objective To investigate the clinical features and treatment of coronary artery perforation after coronary artery interventional therapy (PCI). Methods The perforation causes, imaging characteristics, treatment methods and results of 10 PCI patients with percutaneous coronary intervention from 2004 to 2010 in our hospital were analyzed retrospectively. Results Perforation of the anterior descending artery in 5 cases, 3 cases of supination, right coronary artery in 2 cases, including 5 cases of C-type lesions, B-type lesions in 4 cases, type A lesions in 1 case. Balloon dilatation or stent release pressure is too broad in 3 cases of vascular tear, guide wire out of the blood vessel in 7 cases; 4 cases complicated by tamponade. 6 cases of long-term low-pressure balloon expansion oppression, 4 cases of pericardiocentesis drainage. No one died, no Q wave of myocardial infarction and emergency coronary artery bypass. Conclusion Coronary perforation is a rare complication of PCI, but it can lead to serious clinical consequences, prompt diagnosis and active treatment. It is the key to reduce malignant cardiac events.