冠脉自发性夹层的PCI处理课件.ppt

CAG Angiography Angiography PCI IVUS PRE-Stent implantation After balloon predilatation PCI—Stent in LAD PCI—Stent from LM to LAD Balloon kissing Angiography after kissing IVUS check PCI—Post dilatation Final Result Final Result--IVUS 冠脉自发性夹层的PCI处理 伍贵富 中山大学附属第一医院心内科 卫生部辅助循环重点实验室 2010.10.30 桂林 第7届广西冠心病介入论坛 男/63 反复胸痛6个月 吸烟，高血压 总胆固醇和LDL-C：正常范围 3个月前在他院接受介入诊治 右冠近中段弥漫性狭窄病变（植入支架2枚） 左主干夹层，LAD弥漫性病变（未处理) 7F JL4, BMW*2 Pullback from proximal LAD Voyager 2.0*15mm Voyager 2.5*15mm Resolute 2.5*24mm Resolute 2.75*30mm Resolute 3.5*30mm Quantum 4.0*12mm and Voyager 2.0*15mm Stent in LM malposition IVUS after LM stenting Quantum 5.0*8mm 24ATM 自发性冠状动脉夹层： 有明显内膜破口，CAG显示为管腔内典型“线状透亮影” 血管中层夹层伴血肿形成，但无明显内膜撕裂，仅CAG检查很难诊断。 IVUS有助于自发性夹层的诊断和分型 Shamloo BK Spontaneous coronary artery dissection: aggressive vs. conservative therapy J Invasive Cardiol. 2010 May;22(5):229-30. METHODS: The Medline database was searched for "spontaneous coronary artery dissection" between 1931 and 2008. A total of 440 cases of SCAD were identified. CONCLUSION: Early intervention with either CABG or percutaneous coronary intervention following the diagnosis of SCAD leads to a better outcome and less need for further intervention. Shamloo BK J Invasive Cardiol. 2010 May;22(5):229-30. Shamloo BK J Invasive Cardiol. 2010 May;22(5):229-30. Shamloo BK J Invasive Cardiol. 2010 May;22(5):229-30. Shamloo BK J Invasive Cardiol. 2010 May;22(5):229-30. Shamloo BK J Invasive Cardiol. 2010 May;22(5):229-30. Shamloo BK J Invasive Cardiol. 2010 ;22(5):229-30.