エキシマレーザー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 during Excimer Laser Coronary Angioplasty；Report of a Case

はじめに　冠状動脈インターベンション治療（PCI）において，エキシマレーザーは高度石灰化病変，血栓病変，完全慢性閉塞病変などバルーン拡張が困難な複雑病変に対して有用で，かつ合併症が少ないとされている1～3）．われわれは，エキシマレーザー冠状動脈形成術（ELCA）中に左前下行枝（LAD）の冠状動脈穿孔を発症し，緊急手術によって救命した症例を経験したので報告する．

Coronary perforation during excimer laser coronary angioplasty （ELCA） is a rare but life threatening complication. A 55-year-old man was admitted to our hospital for management of acute coronary syndrome. ELCA was attempted for the left anterior descending coronary artery （LAD）；however, coronary perforation of LAD occurred during the procedure. The patient was transferred to the operation theater and emergency surgical repair was performed. LAD and the diagonal branch were ligated, an aorto-coronary bypass grafting for the distal LAD and the diagonal branch using the saphenous veins. His postoperative course was uneventful, and the patient was discharged on the 23rd postoperative day. In case of coronary perforation complicated by ELCA, immediate surgical repair is essential.