経皮的冠状動脈形成術中に発症した冠状動脈穿孔の1例

Coronary Artery Perforation Secondary to Primary Percutaneous Coronary Intervention；Report of a Case

緊急手術を要する経皮的冠状動脈形成術（percutaneous coronary intervention：PCI）の合併症としては，冠状動脈解離，急性・亜急性冠閉塞，冠状動脈穿孔/破裂，デバイスによる冠状動脈塞栓，不完全血行再建，医原性大動脈解離などがある1）．冠状動脈穿孔の発生頻度は約6％とまれではあるが2），新しいデバイスの導入に伴い発生頻度が増加している3）．われわれは，PCI施行中に冠状

Stent perforation of a coronary artery during percutaneous coronary intervention （PCI） is a rare but life-threatening complication. A 70-year-old man was admitted to our hospital for management of acute coronary syndrome. PCI was attempted for the left circumflex artery （LCX）；however, catheterization was complicated by perforation of the LCX by the stent. He developed cardiac tamponade and was resuscitated using percutaneous cardiopulmonary support. Emergency surgery （ligation of the LCX and aorto-coronary bypass grafting for the distal LCX） was performed. His postoperative course was uneventful, and the patient was discharged on the 20th postoperative day. Collaboration between cardiologists and surgeons is essential to salvage such a critical patient.