経皮的冠状動脈インターベンション施行中のバルーンカテーテル遺残に対する外科的摘出

Surgical Removal of a Retained Balloon Catheter During Percutaneous Coronary Intervention

PCI中に遺残したバルーンカテーテルを外科的に摘出し，術中冠状動脈造影を参考にして冠状動脈バイパス術を追加で施行した1例を経験した．

A 76-year-old man with angina pectoris underwent percutaneous coronary intervention （PCI） of the left anterior descending artery. While attempting to withdraw the balloon catheter, it fractured and became irretrievable, and he was transferred to our hospital. The ascending aorta was incised under cardiopulmonary bypass to remove the retained catheter, which was entangled with a coronary stent, requiring partial excision of the stent to achieve removal. Intraoperative coronary angiography revealed intimal injury of the left coronary artery. Due to the high risk of subsequent dissection and occlusion, coronary artery bypass grafting （CABG） was performed. The postoperative course was uneventful, and the patient was discharged. This case illustrates a rare complication of PCI in which catheter retention with stent entanglement necessitated surgical removal and concomitant CABG. Prompt surgical intervention is necessary in such cases to prevent life-threatening complications.