准分子激光冠状动脉成形术联合血栓抽吸术成功治疗急性心肌梗死合并右冠状动脉大量血栓3例

Excimer laser coronary angioplasty combined with thrombus aspiration catheter successfully treated 3 patients of acute myocardial infarction with massive thrombus in right coronary artery

对于冠状动脉血栓负荷重的患者,当常规手段仍无法恢复理想血流时,准分子激光冠状动脉成形术(ELCA)可作为经皮冠状动脉介入治疗(PCI)的重要辅助手段,其可减少术中慢血流或无复流的发生,提升冠状动脉心肌梗死溶栓治疗试验(TIMI)血流分级,改善心肌灌注,具有较高的即刻成功率和临床成功率。本文报道3例右冠状动脉大量血栓患者使用ELCA联合血栓抽吸,均成功开通血管,血栓负荷明显减少,均获得良好的即刻效果及临床效果,治疗过程中均未发生血管穿孔、心脏压塞等并发症。

For patients with severe coronary thrombosis burden,when conventional methods still cannot restore ideal blood f low,excimer laser coronary angioplasty(ELCA)can be used as an important auxiliary method f or percutaneous coronary intervention(PCI).It can reduce the occurrence of slow blood f low or no-ref low,increase coronary blood f low,improve myocardial perf usion,and achieve higher immediate and clinical success rates.This article introduced the diagnosis and treatment of 3 patients with massive right coronary artery thrombosis treated with ELCA combined with thrombus aspiration.All 3 patients successf ully opened blood vessels,signif icantly reduced the thrombus load,and achieved good immediate and clinical eff ects.No complications such as vascular perf oration and cardiac tamponade occurred during the treatment.