scholarly journals Comparable Periprocedural Outcomes of Percutaneous Coronary Intervention in Male and Female Patients with Type C Lesions

2017 ◽  
Vol 02 (03) ◽  
pp. 021-024
Author(s):  
Narapureddy Reddy ◽  
Nemani Lalita
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Success Rate ◽  
Coronary Intervention ◽  
Circumflex Artery ◽  
Serum Triglycerides ◽  
Left Circumflex Artery ◽  
Percutaneous Coronary ◽  
Type C ◽  
Male Patients

Background Percutaneous coronary intervention (PCI) in type C lesions has low success and has high procedural risk. We aimed at studying the outcomes of PCI in patients with type C lesions. Material and Methods Total 180 patients with type C lesions who underwent PCI from January 2007 to December 2014 were taken into study and analyzed. Results Of 180 patients, 141(78.3%) were males and 39 (21.7%) were females. Mean hemoglobin concentration, mean serum triglycerides, and mean estimated glomerular filtration rate were significantly lower in females compared with males. Seventy-seven (42.8%) patients had lesions in right coronary artery, 67 (37.2%) had lesions in left anterior descending coronary artery, 31 (17.2%) had lesions in left circumflex artery, and 5 (2.8%) had left main coronary artery disease. Complex lesions were common in males. Chronic total occlusion (CTO) was found in 140 cases and other than CTO of type C lesions in 40 patients. Predilatation was done in 169 (93.9%) patients. Successful PCI was done in 157 (87.2%) patients. Lesion could not be crossed in 11 (6.1%) patients. Only plain old balloon angioplasty could be done in 9 (5%) patients. Other complications occurred in 3 (1.67%) patients. There was no difference between female and male patients in requiring predilatation or crossing the lesion or in not being able to deliver the stent. Conclusion PCI success rate among patients with type C lesions was 87.2% with low-complication rate in the present era. There was no difference in between female and male patients in success rate or complications.

scholarly journals Iatrogenic acute aortic dissection caused by intervention for spontaneous coronary artery dissection: a surgical case report

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Yuki Hayashi ◽  
Makoto Taoka ◽  
Shunji Osaka ◽  
Satoshi Unosawa ◽  
Masashi Tanaka
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Type A ◽  
Coronary Intervention ◽  
Artery Dissection ◽  
Circumflex Artery ◽  
Left Circumflex Artery ◽  
Coronary Syndrome ◽  
Left Anterior Descending Artery ◽  
Percutaneous Coronary

Abstract Background Iatrogenic acute aortic dissection (AAD) caused by cardiovascular intervention is rare. Also rare is spontaneous coronary artery dissection (SCAD), a form of acute coronary syndrome, which develops in relatively young women without coronary risk factors. We encountered type A iatrogenic AAD caused by an intervention for SCAD. Case presentation A 53-year-old woman was brought to our hospital after cardiopulmonary resuscitation. She was diagnosed with acute coronary syndrome caused by SCAD, and percutaneous coronary intervention was carried out on her distal left anterior descending artery. The dissection proceeded to the proximal left anterior descending artery and left main coronary artery trunk, so additional percutaneous coronary intervention was performed on the left circumflex artery. After the intervention, type A AAD occurred with a primary entry tear from the left main coronary artery trunk, and computed tomography showed a type A AAD of the aortic arch. We performed emergency ascending aorta replacement and coronary artery bypass grafting to the left anterior descending artery and left circumflex artery. The patient had an uneventful recovery after the operation and was discharged on postoperative day 25. Conclusion To our knowledge, this is the first report of an iatrogenic AAD caused by percutaneous coronary intervention for SCAD.

scholarly journals Bioabsorbable Vascular Scaffolds Eluting with Everolimus: for Percutaneous Coronary Intervention of Patients with de-novo Coronary Artery Lesion: Our Experiences at a Tertiary Hospital

2014 ◽  
Vol 6 (2) ◽  
pp. 122-126
Author(s):  
AHMW Islam ◽  
S Munwar ◽  
S Talukder ◽  
AQM Reza ◽  
T Ahmed ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
De Novo ◽  
Positive Family History ◽  
Coronary Intervention ◽  
Coronary Artery Lesion ◽  
Circumflex Artery ◽  
Left Circumflex Artery ◽  
Percutaneous Coronary ◽  
Vascular Scaffold

Background: Aim of the study was to evaluate the primary procedural success of percutaneous coronary intervention (PCI) of de-novo coronary artery lesion by using Bioabsorbable Vascular Scaffold (BVS) ABSORB stents eluting Everolimus. Methods: Total 16 patients were enrolled in this very preliminary study of BVS absorb. Among them, Male: 11 and Female: 5. Total 20 stents were deployed. Mean age were for Male: 56 yrs, for Female: 60 yrs. Associated coronary artery disease (CAD) risk factors were Dyslipidemia, High Blood pressure, Diabetes Mellitus, Positive family history (FH) for CAD and Smoking. Patients were followed up clinically. Results: Among the study group; 13 (81%) were Dyslipidemic, 10(62.5%) were hypertensive; 6 (37.5%) patients were Diabetic, FH 3(18.75%), and 2(18%) were all male smoker. Female patients were more obese [Body Mass Index (BMI) M 25: F 27] and developed CAD in advance age. A common stented territory was for left anterior descending artery (LAD): 6 (37.5%), left circumflex artery (LCX) 5 (25%), right coronary artery (RCA) 6(37.5%). One patient had both LCX and LAD stenting. Total 3 patients had double/overlapping stent in RCA lesion. Territory wise distributions of BVS ABSORB stent were for LAD 6(30%), RCA 9 (45%), and LCX 5 (25%). There was no periprocedural or postprocedural complication. Conclusion: BVS ABSORB Everolimus eluting vascular scaffold showed favorable clinical outcome without any major cardiac events (acute or late stent thrombosis, MI or death) over a period of 9 month. Thus, BVS ABSORB would be favorable alternative to other available drug eluting metallic stents. DOI: http://dx.doi.org/10.3329/cardio.v6i2.18352 Cardiovasc. j. 2014; 6(2): 122-126

scholarly journals Isolated right ventricular myocardial infarction: a case report

2020 ◽  
Author(s):  
Adeogo Akinwale Olusan ◽  
Paul Francis Brennan ◽  
Paul Weir Johnston
Keyword(s):  
Myocardial Infarction ◽  
Computed Tomography ◽  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Right Ventricular ◽  
Primary Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
Left Circumflex Artery ◽  
Right Ventricular Myocardial Infarction ◽  
Percutaneous Coronary

Abstract Background Isolated right ventricular myocardial infarction (RVMI) due to a recessive right coronary artery (RCA) occlusion is a rare presentation. It is typically caused by right ventricle (RV) branch occlusion complicating percutaneous coronary intervention. We report a case of an isolated RVMI due to flush RCA occlusion presenting via our primary percutaneous coronary intervention ST-elevation myocardial infarction pathway. Case summary A 61-year-old female smoker with a history of hypercholesterolaemia presented via the primary percutaneous coronary intervention pathway with sudden onset of shortness of breath, dizziness, and chest pain while walking. Transradial coronary angiography revealed a normal left main coronary artery, large left anterior descending artery that wrapped around the apex and dominant left circumflex artery with the non-obstructive disease. The RCA was not selectively entered despite multiple attempts. The left ventriculogram showed normal left ventricle (LV) systolic function. She was in cardiogenic shock with a persistent ectopic atrial rhythm with retrograde p-waves and stabilized with intravenous dobutamine thus avoiding the need for a transcutaneous venous pacing system. A computed tomography pulmonary angiogram demonstrated no evidence of pulmonary embolism while an urgent cardiac gated computed tomography revealed a recessive RCA with ostial occlusive lesion. A cardiac magnetic resonance imaging confirmed RV free wall infarction. She was managed conservatively and discharged to her local district general hospital after 5th day of hospitalization at the tertiary centre. Discussion This case describes a relatively rare myocardial infarction presentation that can present with many disease mimics which can require as in this case, a multi-modality imaging approach to establish the diagnosis.

scholarly journals Coronary Artery Hematoma Treated with Fenestration Using a Novel NSE Alpha® Scoring Balloon

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Naohiro Funayama ◽  
Takao Konishi ◽  
Tadashi Yamamoto ◽  
Daisuke Hotta
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Occlusion ◽  
Intramural Hematoma ◽  
Coronary Intervention ◽  
Optimal Management ◽  
True Lumen ◽  
Circumflex Artery ◽  
Left Circumflex Artery ◽  
Scoring Balloon ◽  
Percutaneous Coronary

The optimal management of coronary intramural hematoma has not been defined. We described a case in which coronary occlusion developed due to an intramural hematoma after percutaneous coronary intervention for mid left circumflex artery (LCX). Intravascular ultrasound (IVUS) demonstrated the progression of the intramural hematoma and a totally compressed true lumen. Our approach was based on fenestration with a scoring balloon (NSE Alpha, Goodman, Japan), which allowed the deployment of an additional stent to be avoided. In conclusion, this management can be effectively and safely performed.

scholarly journals The Wire Rendezvous and Chasing Wire Technique in the Bidirectional Approach for the Percutaneous Coronary Intervention for Chronic Total Occlusion with a Single Guiding Catheter

2018 ◽  
Vol 2018 ◽  
pp. 1-6
Author(s):  
Keisuke Nakabayashi ◽  
Daisuke Sunaga ◽  
Nobuhito Kaneko ◽  
Akihiro Matsui ◽  
Kazuhiko Tanaka ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Chronic Total Occlusion ◽  
Coronary Intervention ◽  
Circumflex Artery ◽  
Total Occlusion ◽  
Left Circumflex Artery ◽  
Rendezvous Technique ◽  
Percutaneous Coronary ◽  
The Wire ◽  
Guiding Catheter

A bidirectional approach for percutaneous coronary intervention for chronic total occlusion (CTO-PCI) using ipsilateral collaterals with a single guiding catheter limits procedural choices. The CTO of the left circumflex artery with ipsilateral collateral artery was treated by the bidirectional approach using a single guiding catheter. While the retrograde wire directly crossed the CTO lesion, the microcatheter could not pass the CTO lesion despite the conventional strategies. Therefore, we performed the wire rendezvous and chasing wire techniques. The wire rendezvous technique enables deeper retrograde guidewire progression, and the antegrade microcatheter can reach the CTO entry. The chasing wire technique enables the antegrade guidewire to pass the route made by the retrograde guidewire. These techniques might offer a possible solution for bidirectional CTO-PCI using a single guiding catheter. However, this technique should be considered as a last resort because of the risk of rapid reocclusion.

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