Left main stem coronary artery dissection during coronary angiography

1982 ◽  
Vol 8 (1) ◽  
pp. 35-41 ◽  
Author(s):  
H. H. Kruyswijk ◽  
E. J. Müller
Keyword(s):  
Coronary Artery ◽  
Coronary Angiography ◽  
Main Stem ◽  
Artery Dissection ◽  
Left Main ◽  
Coronary Artery Dissection ◽  
Left Main Stem

scholarly journals Left main stem coronary artery dissection.

Heart ◽  
1980 ◽  
Vol 43 (6) ◽  
pp. 705-708 ◽  
Author(s):  
P J Molloy ◽  
M B Ablett ◽  
K R Anderson
Keyword(s):  
Coronary Artery ◽  
Main Stem ◽  
Artery Dissection ◽  
Left Main ◽  
Coronary Artery Dissection ◽  
Left Main Stem

Spontaneous left main stem coronary artery dissection in a young postpartum woman

2017 ◽  
Vol 18 (9) ◽  
pp. 721-722
Author(s):  
Gianfranco Aprigliano ◽  
Altin Palloshi ◽  
Nuccia Morici
Keyword(s):  
Coronary Artery ◽  
Main Stem ◽  
Postpartum Woman ◽  
Artery Dissection ◽  
Left Main ◽  
Coronary Artery Dissection ◽  
Left Main Stem

scholarly journals Postpartum multi-vessel spontaneous coronary artery dissection in the setting of cocaine and amphetamine use: a case report

2020 ◽  
Author(s):  
Laurna McGovern ◽  
J J Coughlan ◽  
Ross Murphy ◽  
Sadat Edroos
Keyword(s):  
Coronary Artery ◽  
Drug Use ◽  
Coronary Angiography ◽  
Illicit Drug ◽  
Main Stem ◽  
Artery Dissection ◽  
Spontaneous Coronary Artery Dissection ◽  
Left Main ◽  
Coronary Artery Dissection ◽  
Amphetamine Use

Abstract Background  Spontaneous coronary artery dissection (SCAD) is a recognized cause of acute coronary syndrome (ACS). Pregnancy, the postpartum period, and illicit drug use have all been reported as potential triggers. Case summary  We describe the case of a 41-year-old patient who presented to the emergency department with chest pain in the setting of recent cocaine and amphetamine use. The patient was 4 months postpartum following an uncomplicated pregnancy. Past medical history was non-contributory, with no known risk factors for ischaemic heart disease. Electrocardiogram was normal but high-sensitivity troponin T was significantly elevated. Coronary angiography revealed multi-vessel SCAD. This was managed conservatively as the patient remained clinically stable and pain free without high-risk anatomy (left main stem or proximal two-vessel coronary artery dissection). Discussion  Spontaneous coronary artery dissection must be considered in a postpartum patient presenting with ACS, particularly in the context of environmental stressors such as illicit drug use. Coronary angiography is key to determine diagnosis and guide management. Conservative therapy is favoured, except for patients with ongoing ischaemia, haemodynamic instability, and left main stem involvement. In this case, we suspect SCAD occurred due to the haemodynamic effects of cocaine and amphetamines in the context of structural arterial changes of the postpartum state.

scholarly journals Iatrogenic Dissection of Left Main-Stem during Primary PCI for Inferior STEMI: A Catastrophic Complication

2017 ◽  
Vol 5 (1-2) ◽  
pp. 67-71
Author(s):  
CM Shaheen Kabir ◽  
M Liaquat Ali ◽  
Saidur Rahman Khan ◽  
Mashhud Zia Chowdhury ◽  
M Maksumul Haq
Keyword(s):  
Coronary Angiography ◽  
Bypass Surgery ◽  
Main Stem ◽  
Artery Dissection ◽  
High Morbidity ◽  
Left Main ◽  
Coronary Artery Dissection ◽  
Left Main Stem ◽  
Intracoronary Stenting ◽  
Bail Out

Coronary artery dissection is a rare but well-recognized complication of coronary angiography with high morbidity and mortality rate. We present the case of a 54-year-old male who experienced iatrogenic left main-stem (LMS) dissection during transradial coronary angiography for inferior STEMI. The patient was successfully treated by prompt bail-out stenting. Intracoronary stenting is of value in stabilising the patients before emergency bypass surgery and can save lives in LMS complications. Ibrahim Card Med J 2015; 5 (1&2): 67-71

scholarly journals Recurrent coronary artery dissection of left main trunk initially presented with normal coronary angiography

2016 ◽  
Vol 14 (6) ◽  
pp. 164-167
Author(s):  
Masahiko Shibuya ◽  
Kenichi Fujii ◽  
Takahiro Imanaka ◽  
Kenji Kawai ◽  
Tomotaka Ando ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Angiography ◽  
Artery Dissection ◽  
Left Main ◽  
Coronary Artery Dissection ◽  
Main Trunk ◽  
Left Main Trunk ◽  
Normal Coronary Angiography

scholarly journals CORONARY ANGIOGRAPHY LEAD TO LEFT MAIN CORONARY ARTERY DISSECTION AND OCCLUSION: 1 CASE DEAD

Heart ◽  
2012 ◽  
Vol 98 (Suppl 2) ◽  
pp. E215.4-E216
Author(s):  
Cai Jiu-Mei ◽  
Xie Dong-Yang
Keyword(s):  
Coronary Artery ◽  
Coronary Angiography ◽  
Left Main Coronary Artery ◽  
Artery Dissection ◽  
Left Main ◽  
Coronary Artery Dissection

scholarly journals Spontaneous left main coronary artery dissection complicated by pseudoaneurysm formation in pregnancy: role of CT coronary angiography

2009 ◽  
Vol 4 (1) ◽  
Author(s):  
Shahid Rahman ◽  
Mohammed Abdul-Waheed ◽  
Tarek Helmy ◽  
Lynn C. Huffman ◽  
Vipin Koshal ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Angiography ◽  
Left Main Coronary Artery ◽  
Ct Coronary Angiography ◽  
Artery Dissection ◽  
Left Main ◽  
Coronary Artery Dissection ◽  
Pseudoaneurysm Formation ◽  
In Pregnancy

scholarly journals Computed tomography coronary angiogram in left main stem disease: how does it fare against invasive coronary angiography?

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
S Liu ◽  
S Tyebally ◽  
A Ramasamy ◽  
R Bajaj ◽  
T Bajomo ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Predictive Value ◽  
Diagnostic Performance ◽  
Invasive Coronary Angiography ◽  
Main Stem ◽  
Left Main ◽  
Improvement Project ◽  
Left Main Stem

Abstract Funding Acknowledgements Type of funding sources: None. Background Computed Tomography Coronary Angiography (CTCA) is increasingly being used to detect and exclude the presence of coronary artery stenosis. Published studies to date comparing CTCA to invasive coronary angiography (ICA) have focused on epicardial vessels other than the left main stem (LMS) (1 - 4). Despite the diagnostic accuracy of CTCA specifically for LMS disease being unknown, it has been used in a recent multi-centre trial (5). Purpose To evaluate the diagnostic performance of CTCA compared with ICA for the detection and visual grading of native Left Main Stem lesions.  Methods Retrospective study of patients who underwent CTCA and ICA within 12 months as part of a Quality Improvement project, with no prior coronary intervention. CTCA LMS lesions were graded by consensus of 3 independent blinded reviewers using the Coronary Artery Disease - Reporting and Data System (CAD-RADS) (none, minimal, mild, moderate and severe) and ICAs were similarly evaluated by consensus of 2 independent, blinded reviewers. Moderate and severe LMS lesions were considered clinically significant. Results A total of 53 subjects underwent both CTCA and ICA (70% male, mean age: 62). 66% of LMS lesions were found to be significant on ICA. Compared to ICA, CT angiography has a sensitivity of 83% and a specificity of 89% for detecting a significant LMS stenosis of 50% or more, with a positive predictive value of and a negative predictive value of 94% and 73% respectively. CTCA for detecting a significant LMS stenosis has a AUC of 0.88.  In stenosis grading, CTCA correlated with ICA at the same CAD-RADS level in 53% of cases, with over-estimation in 19% and under-estimation in 28% of cases.  Conclusion In this retrospective single centre study of patients with native coronary vessels, CTCA is shown to be accurate in identifying significant LMS lesions detected on ICA. However, at a level of stenosis grading, there is significant inter-modality discrepancy with CTCA associated with over- and under-estimation of LMS lesion severities compared with ICA. Diagnostic Performance of CTCA vs ICA Significant LMS lesion ICA positive ICA negative CTCA positive 29 2 CTCA negative 6 16 Diagnostic Performance of CTCA vs ICA in significant LMS lesions Abstract Figure. Significant LMS lesions:CTCA performance

scholarly journals LEFT MAIN STEM DISEASE ON CORONARY ANGIOGRAPHY IN PATIENTS WITH NON-ST SEGMENT ELEVATION MYOCARDIAL INFARCTION

2021 ◽  
Vol 54 (1) ◽  
pp. 30-33
Author(s):  
Kashif Ali Hashmi ◽  
Momin Rasheed Khan ◽  
Atif Ali Hashmi ◽  
Fahar Adnan ◽  
Muhammad Irfan
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Main Stem ◽  
Left Main ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
Left Main Stem ◽  
St Segment ◽  
Left Main Stem Disease

Objectives: The purpose of our study was to determine the frequency of left main stem disease on coronary angiography in patients with non-ST segment elevation myocardial infarction (NSTEMI). By studying the exact frequency of the left main stem (LMS) disease in NSTEMI patients in our population, we will be able to better risk stratify and plan further management for this group of patients. Methodology: This cross-sectional study was conducted at the Department of Cardiology, Chaudhry Pervez Elahi Institute of Cardiology (CPEIC), Multan from 14-June-2017 to 13-Dec-2017. Total 248 patients with NSTEMI were included in the study. Coronary angiography was done in all selected patients. Diagnosis of LMS disease was made when stenosis in the LMS artery was more than half of the diameter of the left main coronary artery. Results: There were 80.6% male and 19.4% female patients with a mean age 49.39±7.23 years. In this study, 37.1% patients were found with left main stem disease. Among LMS disease patients, there was 82.6% male and 17.4% female patients. 55.4% of patients were aged 50 years and above. 40.2% were smokers and 33.7% were diabetic. No significant association of LMS was found with the age group (p=0.66), gender (p=0.54), smoking status (p=0.54) and diabetes mellitus (p=0.95). Conclusion: In this study, we found a high frequency of LMS disease in our population. This subset of patients with NSTEMI requires early re-vascularization. This also signifies a need to re-evaluate our screening programs and management protocols related to coronary artery disease.

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