scholarly journals TCTAP C-071 Successful Fenestration of a Polytetrafluoroethylene-covered Stent Crossing over the Left Circumflex Artery After Coronary Perforation

2014 ◽  
Vol 63 (12) ◽  
pp. S110
Author(s):  
Norimasa Taniguchi
Keyword(s):  
Covered Stent ◽  
Crossing Over ◽  
Circumflex Artery ◽  
Left Circumflex Artery ◽  
Coronary Perforation

scholarly journals Modified double guiding catheter ‘Ping Pong’ technique to treat large coronary perforation: a case report

2021 ◽  
Vol 5 (5) ◽  
Author(s):  
Himanshu Gupta ◽  
Navjyot Kaur ◽  
Yashpaul Sharma ◽  
Soo Teik Lim
Keyword(s):  
Strong Support ◽  
Covered Stent ◽  
Circumflex Artery ◽  
Femoral Access ◽  
Left Circumflex Artery ◽  
Coronary Syndrome ◽  
Guide Catheter ◽  
Ping Pong ◽  
Coronary Perforation ◽  
Guiding Catheter

Abstract Background  Despite improvement in available tools and techniques, procedural complications like coronary perforation can occur during percutaneous coronary intervention (PCI). Severe proximal coronary perforations are usually caused by balloon and vessel size mismatch but can also occur with appropriately sized balloons or stents if the coronary vessel has very eccentric calcification or if there is negative remodelling of the vessel. Case summary  A 74-year-old man with a history of type II diabetes mellitus, hypertension, and chronic coronary syndrome (previous PCI 10 years before) presented with unstable angina of 2 weeks of duration. Coronary angiography revealed a patent stent in left anterior descending artery, significant disease in left circumflex artery and diffuse calcified lesion in dominant right coronary artery (RCA). During angioplasty of RCA, the patient developed severe Ellis grade III perforation, which was successfully managed with modified double guiding catheter ‘Ping Pong’ technique. In this technique, the already engaged 7 French (F) Amplatz Left 1 guide catheter was used to deliver the bulky covered stent in highly tortuous and calcified RCA while a second 6F guide catheter (Judkin Right) introduced through contralateral femoral access was used for introducing the balloon, which initially sealed the perforation and subsequently acted as a distal anchor to provide strong support to deliver the covered stent. Conclusion  In a case of severe coronary perforation, modified Ping Pong technique using a small-sized second guide catheter complimentary to the first guide catheter, can be used to deploy bulky covered stent.

P6526Short and long-term outcomes of coronary perforation managed by coil embolization: a single-center experience

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
Q Qin ◽  
J Y Ma ◽  
F Zhang ◽  
L Ge ◽  
J Y Qian ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Coil Embolization ◽  
Chronic Total Occlusion ◽  
Coronary Intervention ◽  
Long Term Outcomes ◽  
Circumflex Artery ◽  
Total Occlusion ◽  
Left Circumflex Artery ◽  
Coronary Perforation

Abstract Background Coronary perforation is a serious complication in percutaneous coronary intervention (PCI), as it can lead to pericardial effusion causing tamponade, often necessitating emergency pericardiocentesis and rarely, cardiac surgery. With increasing treatment of complex coronary lesions, such as chronic total occlusion (CTO), the incidence of coronary perforation is also increasing. Distal wire perforation and collateral vessel perforation can be managed by coil embolization during PCI, which prevented the need of cardiac surgery. Purpose To report the short and long-term outcomes of patients with coronary perforation as a complication of PCI managed by coil embolization in our center Methods We retrospectively analyzed 66 patients who had coronary perforation treated by coil embolization during PCI from 32007 PCI procedures performed in our center from Oct 2012 to June 2018. Results Of sixty-six cases of coronary perforation, twenty-six cases were distal coronary perforation, while 40 cases were collateral perforation. The average coil number used in distal coronary and collateral perforation lesion is 1.8±0.9 and 1.8±1.0, respectively. The maximum number of coil implanted in each patient is 4 in both groups. Two emergency cardiac surgery to seal the perforation was performed after coil embolization in distal coronary perforation and pericardiocentesis, including one distal left circumflex artery perforation and one distal left anterior descending artery perforation. In collateral perforation, one case of CABG was performed due to myocardial ischemia caused by CTO lesion. During a follow-up of 707±476 days, one patient in collateral perforation group had CABG one month later, while no death or myocardial infarction (MI) was detected. Fifty-four (81.2%) cases of perforations occurred while treating chronic total occlusion, and 74.0% of these perforations were located in collateral vessels, mostly epicardial vessels. Thirty-nine CTO cases (72.2%) were revascularized successfully with the aid of coil embolization. Conclusion Coil embolization is feasible and effective in treating distal coronary perforation and collateral perforation during PCI procedure. In CTO lesions, coil embolization facilitates the success of revascularization by PCI.

Prevalence and Localization of Hibernating Myocardium Among Patients with Left Ventricular Dysfunction

2019 ◽  
Vol 15 (9) ◽  
pp. 884-889
Author(s):  
Emine Acar ◽  
Ayşegül Aksu ◽  
Gökmen Akkaya ◽  
Gamze Çapa Kaya
Keyword(s):  
Scar Tissue ◽  
Left Ventricular ◽  
Hibernating Myocardium ◽  
Circumflex Artery ◽  
Irrigation Area ◽  
Left Circumflex Artery ◽  
Pet Ct ◽  
Perfusion Defects ◽  
The Right ◽  
Fdg Pet Ct

Objective: This study evaluated how much of the myocardium was hibernating in patients with left ventricle dysfunction and/or comorbidities who planned to undergo either surgical or interventional revascularization. Furthermore, this study also identified which irrigation areas of the coronary arteries presented more scar and hibernating tissue. Methods: At rest, Tc-99m MIBI SPECT and cardiac F-18 FDG PET/CT images collected between March 2009 and September 2016 from 65 patients (55 men, 10 women, mean age 64±12) were retrospectively analyzed in order to evaluate myocardial viability. The areas with perfusion defects that were considered metabolic were accepted as hibernating myocardium, whereas areas with perfusion defects that were considered non-metabolic were accepted as scar tissue. Results: Perfusion defects were observed in 26% of myocardium, on average 48% were associated with hibernation whereas other 52% were scar tissue. In the remaining Tc-99m MIBI images, perfusion defects were observed in the following areas in the left anterior descending artery (LAD; 31%), in the right coronary artery (RCA; 23%) and in the Left Circumflex Artery (LCx; 19%) irrigation areas. Hibernation areas were localized within the LAD (46%), LCx (54%), and RCA (64%) irrigation areas. Scar tissue was also localized within the LAD (54%), LCx (46%), and RCA (36%) irrigation areas. Conclusion: Perfusion defects are thought to be the result of half hibernating tissue and half scar tissue. The majority of perfusion defects was observed in the LAD irrigation area, whereas hibernation was most often observed in the RCA irrigation area. The scar tissue development was more common in the LAD irrigation zone.

Hypoplastic Left Circumflex Coronary Artery: Imaging Findings with Coronary Computed Tomography Angiography - A Case Report

2019 ◽  
Vol 15 (4) ◽  
pp. 427-429
Author(s):  
Asli Tanrivermis Sayit ◽  
Cetin Celenk
Keyword(s):  
Computed Tomography ◽  
Coronary Artery ◽  
Coronary Computed Tomography Angiography ◽  
Coronary Artery Imaging ◽  
Circumflex Coronary Artery ◽  
Circumflex Artery ◽  
Coronary Computed Tomography ◽  
True Incidence ◽  
Left Circumflex Artery ◽  
Artery Disease

<P>Background: Hypoplastic coronary artery disease is a rare congenital coronary artery anomaly. It is often detected incidentally, and its true incidence in the general population is not known. </P><P> Discussion: Symptoms of HCAD are syncope, palpitations, dyspnea, and chest pain. Also, arrhythmia and myocardial infarction can be seen; these can cause sudden death, especially in athletes and young people. Diagnosis is often made at autopsy. Conclusion: Here, we present the case of a 39-year-old male with isolated hypoplasia of the left circumflex artery detected by coronary Computed Tomography (CT) angiography who complained of palpitation.</P>

scholarly journals The “criminal” artery of de Winter may be the left circumflex artery

Medicine ◽  
2020 ◽  
Vol 99 (24) ◽  
pp. e20585
Author(s):  
Dongpu Shao ◽  
Na Yang ◽  
Shanshan Zhou ◽  
Qingyuan Cai ◽  
Rangrang Zhang ◽  
...  
Keyword(s):  
Circumflex Artery ◽  
Left Circumflex Artery

scholarly journals Left Circumflex Artery Rupture with Left Atrial Tamponade and Functional Mitral Stenosis

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Weiting Huang ◽  
Khaled Mohamed Emadeldin Moheb Hammad ◽  
Victor Tar Toong Chao ◽  
Khung Keong Yeo
Keyword(s):  
Left Atrium ◽  
Coronary Sinus ◽  
Mitral Stenosis ◽  
Left Atrial ◽  
Pulmonary Veins ◽  
Fluid Collection ◽  
Artery Dissection ◽  
Circumflex Artery ◽  
Left Circumflex Artery ◽  
Coronary Syndrome

The growth in percutaneous transluminal devices has enabled operators to tackle more complex, native, and post-bypass surgery anatomy. However, complications such as coronary artery dissection, coronary perforation, retrograde aortic dissection, arrhythmias, and acute coronary syndrome still occur with resulting mortality rates of up to 4.2% in complex interventions. Perforation of the circumflex artery is of particular interest in view of its position and relation to the surrounding cardiac structures. This is a site of potential fluid collection, and as the left atrium is fixed to the parietal pericardium at the entry of the pulmonary veins, fluid in the oblique sinus can accumulate enough pressure to compress the left atrium and the coronary sinus. We present a case of left circumflex artery perforation which demonstrates the physiologic complications of coronary sinus and left atrial compression and the resultant functional mitral stenosis.

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