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目的 回顾性分析 8例冠状动脉穿孔的原因、处理及其近期预后。方法 回顾性分析 1995～ 2 0 0 2年 8例冠状动脉穿孔患者的临床资料、造影征象、穿孔原因、处理过程及近期预后和转归 ,其中男 3例 ,女 5例 ,平均年龄为 5 9岁。结果 经皮冠状动脉腔内成形术 (PTCA)导丝损伤所致穿孔 4例 ,球囊扩张或支架释放过程中压力过大致血管破裂 4例。 3例行球囊压迫 ,1例行球囊压迫 +急诊冠状动脉旁路移植术 (CABG) ,1例行弹簧圈栓堵 +带膜支架置入 ,其余 2例小分支穿孔无水乙醇封堵。心包填塞 4例 ,死亡 3例。结论 冠状动脉穿孔是经皮冠状动脉介入治疗 (PCI)过程中较为凶险的一种并发症 ,部分患者短时间内即可发生心包填塞 ,甚至死亡 ,及时诊断、积极治疗是减少患者病死率的关键
Objective To retrospectively analyze the causes, treatment and prognosis of 8 cases of coronary artery perforation. Methods The clinical data, imaging features, causes of perforation, treatment and prognosis of 8 patients with coronary artery perforation from 1995 to 2002 were retrospectively analyzed. There were 3 males and 5 females with an average age of 59 year old. Results Percutaneous transluminal coronary angioplasty (PTCA) caused 4 cases of perforation caused by the injury of the guidewire, balloon dilatation or release of stent in the course of excessive vascular rupture. 3 underwent balloon compression, 1 underwent balloon compression + emergency coronary artery bypass grafting (CABG), 1 underwent coil embolization + stent placement, and the remaining 2 small branches were punctured with ethanol . 4 cases of cardiac tamponade, 3 cases of death. Conclusions Coronary perforation is a more dangerous complication during percutaneous coronary intervention (PCI). Some patients may have cardiac tamponade or even death within a short period of time, and timely diagnosis and aggressive treatment are the key to reducing patient mortality