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冠状动脉支架脱载及其处理(摘要)

Coronary Stent Migration and its Management

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【作者】 马长生颜红兵王勇周玉杰李宪伦郑知刚李宵柯元南

【Author】 Department of Cardiology , China Japan Friendship Hospital , Beijing (100029) Ma Changsheng , Yan Hongbing , Wang Yong ,et al-(

【机构】 中日友好医院心内科!100029

【Abstract】 Objective : To present coronary stent migrations in 4 cases in order to improve an ability to prevent and manage them- Methods and Results : ①From August ,1995 to June ,1999 ,397 stenosis in 327 cases were treated with implantation of 425 coronary stents- Of 397 stenosis ,type Alesions accounted for 16-4 % ,type B1lesions 29-5 % ,type B2lesions 39-8 % and type Clesions 14-4 % - Four stents were migrated with an incidence of 0-9 % (4/425) including one Bestent (4-0 m m ×15-0 m m ) stent, on AVE (3-0 m m ×15-0 m m) stent and two Crossflex LC (3-0 m m ×27-0 m m) stents- ②Probable causes of stent migration- In cases 3 and 4 ,it was a failed stent passing through a stenosis because of a poor predialation of a long eccentric stenosis or an injured left main coronary artery resulted from an excess inserting- After a retrospective analysis , we believe that the stent migration could have been prevented in case 1 if the second stent was not delivered until a guiding catheter passed through the first stentlocated at ostium of the right coronary artery- The stent migration in case 2 resulted from a poor cooperation between operators- ③ Migration management- In cases 1 and 2 ,2 migrated stents were pushed into a branch of a limb artery because of unavailable microcoil retrieval- In case 4 ,the migrated stent was delivered right atthe spot because it was difficult to be moved eitherfor word or backward- In case 3 ,the migrated stent was successfully removed from the artery by using the microcoil retrieval- Conclusion : Astent migration is one ofthe complications hard to cope with during a coronary stenting procedure- If a proper management could not be achieved , a severe complication would happen as in case 4- Therefore , an improvement of operators′general skills , an understanding of characteristic anatomy of a target vessel ,a proper selection of stents ,guiding catheters and guide wires ,and an adequate predilation are needed to prevent a stent migration- When a migration occurs , all available management procedures including bypass surgery should be considered , and a microcoilretrievaltechnique , which has been proven to be a simple ,safe and effective method ,should be tried at first

  • 【文献出处】 中国循环杂志 ,CHINESE CIRCULATION JOURNAL , 编辑部邮箱 ,1999年S1期
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