scholarly journals Superficial temporal artery access for percutaneous coronary artery stenting during the COVID-19 pandemic: a case report

2020 ◽  
Author(s):  
Ádám Csavajda ◽  
Olivier F Bertrand ◽  
Béla Merkely ◽  
Zoltán Ruzsa
Keyword(s):  
Coronary Artery ◽  
Superficial Temporal Artery ◽  
Temporal Artery ◽  
Coronary Intervention ◽  
Femoral Access ◽  
St Segment Elevation ◽  
Invasive Cardiology ◽  
Percutaneous Coronary ◽  
Diagnostic Angiography ◽  
The Right

Abstract Background The COVID-19 pandemic creates new challenges for healthcare, including invasive cardiology. Case summary We discuss the case of a 65-year-old man who presented with non-ST segment elevation myocardial infarction combined with bilateral pneumonia. The patient had known severe iliac artery lesions with prior interventions and bilateral subclavian artery occlusions. After unsuccessful femoral artery access, the diagnostic angiography and the right coronary artery percutaneous coronary intervention were successfully performed from ultrasound-guided lower superficial temporal artery access. Discussion We showed that superficial temporal access can be used as an alternate access site for diagnostic coronary angiography and intervention when standard wrist and femoral access sites are not readily accessible.

scholarly journals Acute Thrombotic Coronary Occlusion in a Patient with Coronary Artery Anomaly

2017 ◽  
Vol 2 (3) ◽  
pp. 266-269
Author(s):  
Elena Beganu ◽  
Elisabeta Himcinschi ◽  
Roxana Hodas ◽  
Daniel Cernica ◽  
Ioana Rodean
Keyword(s):  
Coronary Artery ◽  
Coronary Intervention ◽  
Circumflex Artery ◽  
St Segment Elevation ◽  
Left Circumflex Artery ◽  
St Segment ◽  
Percutaneous Coronary ◽  
Atherosclerosis Development ◽  
The Right ◽  
Abnormal Anatomy

Abstract Patients with coronary artery anomalies are more susceptible to develop acute thrombotic coronary occlusions due to the abnormal anatomy of these arteries and the disturbance of the pathophysiological mechanisms that lead to an accelerated atherosclerosis development. The following article presents the case of a 64-year-old female patient diagnosed with anterior ST-segment elevation myocardial infarction. The patient underwent primary percutaneous coronary intervention, which revealed the absence of the right coronary artery and separated origins of the left anterior descending artery and the left circumflex artery from the aorta.

scholarly journals A case report of an iatrogenic coronary cameral fistula treated by retrograde percutaneous coronary intervention

2020 ◽  
Vol 4 (3) ◽  
pp. 1-6
Author(s):  
Paul Ohayon ◽  
Anthony Matta ◽  
Nicolas Boudou
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Coronary Intervention ◽  
Left Ventricular ◽  
Complete Revascularization ◽  
Primary Pci ◽  
Invasive Cardiology ◽  
Percutaneous Coronary ◽  
Coronary Cameral Fistula ◽  
The Right

Abstract Background Acquired coronary cameral fistula is an extremely rare condition that involves an abnormal communication between a coronary artery and a cardiac chamber. It usually occurs after chest trauma or cardiovascular interventions, such as percutaneous coronary intervention (PCI) and is associated with various outcomes, ranging from a stable status to haemodynamic instability. Acquired coronary cameral fistula frequently arises from the right coronary artery and drains generally into the right ventricle. Case summary We report the unusual case of a 56-year-old male patient referred to an invasive cardiology centre for a suspected left anterior descending (LAD) coronary–left ventricular (LV) fistula resulting from a primary PCI for an anterior ST-elevation myocardial infarction. Here, the confirmed LAD–LV fistula was successfully treated by retrograde PCI with covered stent implantation. Clinical and angiographic outcomes were favourable at 1-month follow-up. Discussion Coronary cameral fistula can be a severe complication of primary PCI. Various treatment strategies can be considered based on haemodynamic status and anatomical features. In the case described herein, the use of a retrograde approach led to permanent fistula closure and complete revascularization.

Should Percutaneous Coronary intervention be the Standard Treatment Strategy for Significant Coronary Artery Disease in all Octogenarians?.

2020 ◽  
Vol 16 ◽  
Author(s):  
George Kassimis ◽  
Grigoris V. Karamasis ◽  
Athanasios Katsikis ◽  
Joanna Abramik ◽  
Nestoras Kontogiannis ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Elderly Patients ◽  
Symptom Relief ◽  
Coronary Intervention ◽  
St Segment Elevation ◽  
St Segment ◽  
Percutaneous Coronary ◽  
Artery Disease

Coronary artery disease (CAD) remains the leading cause of cardiovascular death in octogenarians. This group of patients represents nearly a fifth of all patients treated with percutaneous coronary intervention (PCI) in real-world practice. Octogenarians have multiple risk factors for CAD and often greater myocardial ischemia than younger counterparts, with a potential of an increased benefit from myocardial revascularization. Despite this, octogenarians are routinely under-treated and belittled in clinical trials. Age does make a difference to PCI outcomes in older people, but it is never the sole arbiter of any clinical decision, whether in relation to the heart or any other aspect of health. The decision when to perform revascularization in elderly patients and especially in octogenarians is complex and should consider the patient on an individual basis, with clarification of the goals of the therapy and the relative risks and benefits of performing the procedure. In ST-segment elevation myocardial infarction (MI), there is no upper age limit regarding urgent reperfusion and primary PCI must be the standard of care. In non-ST-segment elevation acute coronary syndromes, a strict conservative strategy must be avoided; whereas the use of a routine invasive strategy may reduce the occurrence of MI and need for revascularization at follow-up, with no established benefit in terms of mortality. In stable CAD patients, invasive therapy on top of the optimal medical therapy seems better in symptom relief and quality of life. This review summarizes the available data on percutaneous revascularization in the elderly patients and particularly in octogenarians, including practical considerations on PCI risk secondary to ageing physiology. We also analyse technical difficulties met when considering PCI in this cohort and the ongoing need for further studies to ameliorate risk stratification and eventually outcomes in these challenging patients.

scholarly journals Coronary–Cameral Fistula Caused by Guidewire Trauma and Resolved by Coil Embolization

2016 ◽  
Vol 43 (4) ◽  
pp. 338-340 ◽  
Author(s):  
Suvro Banerjee ◽  
Soumya Patra
Keyword(s):  
Coronary Artery ◽  
Right Ventricular ◽  
Coil Embolization ◽  
Coronary Intervention ◽  
Effort Angina ◽  
Coronary Angiogram ◽  
Vessel Disease ◽  
Percutaneous Coronary ◽  
Coronary Cameral Fistula ◽  
The Right

A 57-year-old woman presented with effort angina. A coronary angiogram revealed critical 2-vessel disease, for which she subsequently underwent percutaneous coronary intervention. During angioplasty, a coronary guidewire—inadvertently passed into the right ventricle through the septal branches of the posterior descending coronary artery—caused a coronary artery-to-right ventricular fistula. This fistula was successfully closed percutaneously by coil embolization. To our knowledge, this is the first report of a case in which a coronary artery-to-right ventricular fistula caused by a guidewire was managed successfully by coil embolization.

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