PTCA後生じた冠動脈解離を血管内エコーにて観察しえた1例

A Case Involving Coronary Dissection Caused after PTCA that was Observed with Intravascular Echocardiography

　冠動脈形成術後，冠動脈解離を生じ冠動脈造影にて経過観察し，1年半後の造影上解離腔は消失したが，血管内エコーでは解離腔内の血栓性閉塞を観察しえた1例を経験した．症例は67歳，女性．1991年2月，胸痛にて来院，心電図にてV_4-6誘導にてST上昇を認め，急性心筋梗塞と診断し，回旋枝閉塞に対しPTCRを施行し90％狭窄にまで改善した．1カ月後回施枝の閉塞を認めPTCAを施行し，同部位に広範な解離像を形成した．1年半後，造影では解離腔は消失したが，血管内エコーでは解離腔内の血栓性閉塞が観察された．

We encountered a case that was observed on coro-nary angiography (CAG) during coronary dissection after coronary angioplasty (PTCA) in which the dis-sected cavity disappeared on CAG but thrombolitic obstruction in the dissected cavity could be observed by intravascular echocardiography (IVUS). A 67-year-old woman was admitted with a diagnosis of acute myocar-dial infarction with ST elevation when experiencing chest pain. PTCR was performed for obstruction of the left circumflex artery (LCX) and the stenosis was improved to 90 percent.