Instructive percutaneous coronary intervention to avoid the risk of side branch occlusion at a lesion with a lotus root appearance: a case report
Instructive percutaneous coronary intervention to avoid the risk of side branch occlusion at a lesion with a lotus root appearance: a case report
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DOI：
10.1186/s12872-016-0335-y
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发表时间：
2016-08-02
影响因子：
2.1
通讯作者：
Tatsumi, Tetsuya
中科院分区：
文献类型：
--
作者：
Nomura, Tetsuya;Kato, Taku;Tatsumi, Tetsuya
背景：莲藕样病变是一种罕见的病变，很少有机会对这种病变进行冠状动脉介入治疗。由于其特殊的解剖特征，经皮冠状动脉介入治疗（PCI）的问题之一，这些病变是涉及的分支vessel.Case介绍：我们遇到了一个病例PCI的狭窄病变与莲藕外观在中部的右冠状动脉（RCA）。为了避免在主RCA中展开支架导致右心室（RV）分支闭塞的风险，我们通过交通血管腔，通过最接近RV分支口的点，将第三根导丝再次穿过主RCA。此后，我们部署了一个药物洗脱支架在主RCA的RV分支交叉，和RV分支的开口保持完整，正如我们所料，结论：这种情况下是第一份报告在世界上描述的细节，如何保持通畅的侧分支分叉病变的莲藕外观下光学相干断层扫描的指导。
Background: A lotus root appearance is a rare entity, and there is little opportunity to perform coronary intervention for this kind of lesion. Because of its peculiar anatomical characteristics, one of the problems regarding percutaneous coronary intervention (PCI) for these lesions is related to the involvement of branch vessels.Case presentation: We encountered a case of PCI for a stenotic lesion with a lotus root appearance in the mid-portion of the right coronary artery (RCA). To avoid the risk of right ventricular (RV) branch occlusion due to stent deployment in the main RCA, we re-crossed the third guidewire into the main RCA via the nearest point to the RV branch ostium through the communicating vascular lumen. Thereafter, we deployed a drug-eluting stent in the main RCA crossing over the RV branch, and the ostium of the RV branch remained intact, as we expected.Conclusions: This case is the first report in the world describing the details of how to maintain the patency of the side branch bifurcating from a lesion with a lotus root appearance under optical coherence tomography guidance.