1、Ostial LAD LesionOstial LAD LesionDistal ReferenceDistal ReferenceLCXLCXMLA = MLA = 5.7 mm5.7 mm2 2Lumen CSA = 11.9 mmLumen CSA = 11.9 mm2 2Lumen Diameter = 3.5 mmLumen Diameter = 3.5 mm病变病变10 mm10 mmLumen CSA = 18.3 mmLumen CSA = 18.3 mm2 2Lumen Diameter = 5.0 mmLumen Diameter = 5.0 mmLumen CSA = 3
2、.6 mmLumen CSA = 3.6 mm2 2Lumen Diameter = 1.3 mmLumen Diameter = 1.3 mmn IVUS IVUS提示严提示严重钙化病变重钙化病变D2D2D1D1D2D2D2D2D2D2D2D2MSA=4.2mm2 ?Pre-Pre-InterventionInterventionPost-StentPost-Stent离线分析离线分析 测量测量3. Plaque + Media CSA (mm3. Plaque + Media CSA (mm2 2) )4. Minimum lumen diameter (mm)4. Minimum lum
3、en diameter (mm)1. Lumen cross sectional area (mm1. Lumen cross sectional area (mm2 2) )2. External elastic membrane CSA (mm2. External elastic membrane CSA (mm2 2) )5. Calcium arc (5. Calcium arc ( ) )MLAMLA破裂结束破裂结束纤维帽纤维帽斑块破裂斑块破裂真性动脉瘤真性动脉瘤 假性动脉瘤假性动脉瘤 复杂斑块复杂斑块 临近临近狭窄的正常段狭窄的正常段Fibrous CapFibrous CapL
4、ipid CoreLipid CoreProximal斑块破裂合并血栓斑块破裂合并血栓主支和分支中均存在血栓主支和分支中均存在血栓02.06.0mm充盈缺损:钙化结节充盈缺损:钙化结节 “心肌桥心肌桥”Proximal5555岁,女性岁,女性, AMI, AMI“自发性夹层自发性夹层”A AB BC CD DBACD4242岁,男性,岁,男性, 不稳定性心绞痛不稳定性心绞痛正常动脉,血肿正常动脉,血肿Maehara et al. AJC 2002软斑块软斑块组织突出组织突出斑块破裂斑块破裂远端血管远端血管充满血栓充满血栓急性心肌梗死(无复流)急性心肌梗死(无复流)05.020.0mm夹层夹层钙化钙化NoImage