BackgroundCoronary artery dissections are caused by a tear in the vessel endothelium, resulting in blood extravasation into the subintimal space, with subsequent intramural hematoma (IMH). One potential technique to deal with this complication is the use of cutting balloons, however, a significant number of cases experienced distal propagation of the hematoma. We describe a novel technique that enhances the possibility of creating intimal tears between the false and true lumen, aiding in hematoma drainage and restoring distal coronary flow.MethodsWe conducted a retrospective analysis of seven consecutive patients who underwent percutaneous coronary intervention complicated by flow‐limiting intramural hematomas. All patients were treated using the “Cuttering Technique,” based on the operators’ preference. Procedural success was defined as achieving a distal thrombolysis in myocardial infarction 3 (TIMI 3) flow.ResultsIn five out of seven patients treated with “Cuttering Technique” we observed a complete restoration of TIMI 3 flow into the dissected segment.ConclusionsOur cases show the effectiveness of the “Cuttering Technique” as a viable approach for managing IMHs. This technique enhances the possibility of creating intimal tears between the false and true lumens, aiding in hematoma drainage and restoring distal coronary flow.

中文翻译：

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“切割（切割打点球囊）技术”治疗限流冠状动脉壁内血肿


背景冠状动脉夹层是由血管内皮撕裂引起的，导致血液外渗到内膜下空间，随后出现壁内血肿（IMH）。处理这种并发症的一种潜在技术是使用切割球囊，然而，大量病例经历了血肿的远端扩散。我们描述了一种新技术，该技术增强了假腔和真腔之间产生内膜撕裂的可能性，有助于血肿引流和恢复远端冠状动脉血流。方法我们对连续七名接受经皮冠状动脉介入治疗并发限流壁内治疗的患者进行了回顾性分析血肿。根据操作者的喜好，所有患者均使用“切割技术”进行治疗。手术成功的定义是在心肌梗死 3 (TIMI 3) 血流中实现远端溶栓。结果在接受“切割技术”治疗的 7 名患者中，有 5 名我们观察到 TIMI 3 血流完全恢复到解剖段中。结论我们的病例显示了有效性“切割技术”作为管理 IMH 的可行方法。这项技术增加了假腔和真腔之间产生内膜撕裂的可能性，有助于血肿引流和恢复远端冠状动脉血流。