A case of coronary artery disease with rapid progress triggered by stent implantation

Drug-eluting stents (DESs) have a low prevalence of in-stent restenosis. However, we describe a patient with coronary artery disease with rapid progress, which might have been triggered by implantation of a DES. The patient was a 72-year-old woman who was first admitted to hospital with non-ST-segment elevated myocardial infarction and had a DES implanted after coronary angiography showed severe stenosis of the left circumflex artery. However, although she kept taking dual antiplatelet therapy, her condition deteriorated and she was admitted to hospital three more times. Angiography showed that the coronary stenosis had become more severe and was more severe not just in the stent-implanted segments, but also in other coronary arteries. Another DES and drug-eluted balloon were used. However, the stent-implanted and balloon-dilated segments became severely stenosed within 1 month. Tests for auto-immune diseases and allergies were negative. We speculate that the first DES triggered an unknown response of the coronary arteries and led to severe stenosis from the stent-implanted segment to the distal segment and other arteries.

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MDCT detection of congenital absence of the left circumflex artery associated with atherosclerotic coronary artery disease

International Journal of Cardiology ◽

10.1016/j.ijcard.2005.09.045 ◽

2006 ◽

Vol 113 (3) ◽

pp. 408-409 ◽

Cited By ~ 5

Author(s):

Yuichi Sato ◽

Naoya Matsumoto ◽

Makoto Ichikawa ◽

Kanae Nakanishi ◽

Shunicni Yoda ◽

...

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Congenital Absence ◽

Circumflex Artery ◽

Left Circumflex Artery ◽

Artery Disease

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The significant coronary tortuosity and atherosclerotic coronary artery disease; What is the relation?

Journal of Cardiovascular and Thoracic Research ◽

10.15171/jcvtr.2018.36 ◽

2018 ◽

Vol 10 (4) ◽

pp. 209-213

Author(s):

Mohsen Khosravani-Rudpishi ◽

Adel Joharimoghadam ◽

Elham Rayzan

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Anatomical Variation ◽

Cross Sectional Study ◽

Circumflex Artery ◽

Cross Sectional ◽

Timi Frame Count ◽

Left Circumflex Artery ◽

Artery Disease ◽

Coronary Tortuosity

Introduction: Although coronary tortuosity is relatively common in coronary angiograms, there is much debate over the significance of this anatomical variation. So in this study the relation between significant coronary tortuosity (SCT) and coronary artery disease (CAD) was examined. Methods: The cross-sectional study included 737 patients (57% male) who were admitted to the hospital for a coronary angiography, based on their symptoms or non-invasive imaging. Coronary arteries defined as SCT are in the presence of either ≥3 consecutive curvatures of 90◦ to 180◦ or ≥2 consecutive curvatures of ≥180◦ measured at the end-diastole, in a major epicardial coronary artery ≥2 mm in diameter. Results: 29.17% of the patients had SCT of which females (64.7% vs. 34.1%, P< 0.001) and higher aged persons (62.9±8.4 vs. 57.8±10.7 years ± SD; P < 0.001) were significantly associated with SCT compared to non-SCT. Left anterior descending artery (LAD), left circumflex artery (LCX) and right coronary artery (RCA) with SCT in comparison to non-SCT, had lesser probability of CAD with stenosis severity of ≥50% (34.5% vs. 46.1%; P = 0.019 and 17.7% vs. 31.1%; P = 0.001 and 27.9% vs. 43.5%; P = 0.013 respectively) and also had significant lower Gensini scores (4.1±5.3 vs. 8.4±11.9; P = 0.011; 2.1±3.4 vs. 5.2±9.5; P = 0.01 and 1.2±1.9 vs. 5.03±8.9; P < 0.001 respectively) but higher TIMI frame count (15.7±5.3 vs. 11.9±4.6; P < 0.001 and 17.1±4.4 vs. 12.7±4.4; P < 0.001 and 15.2±3.9 vs. 11.6±4.8; P < 0.001 respectively). Conclusion: SCT is negatively correlated with CAD and there is a significant association between SCT and reduced coronary flow rate.

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A Study of Coronary Artery Disease in the Left Circumflex Artery via Artificial Vessel Restoration

10.1101/2020.05.27.119628 ◽

2020 ◽

Author(s):

Akhil Paulraj ◽

Fei Liu

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Numerical Simulations ◽

Cross Sections ◽

Flow Characteristics ◽

Circumflex Artery ◽

Left Circumflex Artery ◽

Flow Vorticity ◽

Artificial Vessel ◽

Artery Disease

AbstractDiagnosis, risk analysis, and treatment of coronary artery disease (CAD) can be improved with a better understanding of cardiovascular flows. Numerical simulations can assist in achieving this understanding. The objective of this study is to compare the dynamics of blood flow in a diseased left circumflex artery (LCX) and its artificially restored counterpart representing its healthy state. This comparison is made to identify flow characteristics in the restored vessel that contribute to the development of CAD. The diseased LCX geometry was derived from computed tomography angiography data. The stenosed region of the diseased LCX was repaired by manually redefining cross-sections of the vessel, creating the restored geometry. To account for inaccuracies, variations of the restored LCX were made by dilating the repaired surface. Numerical simulations were conducted on all geometries and the results were compared. Alongside expected low wall shear stress, a region of high vorticity was present in all of the restored vessels near the location where CAD developed in the diseased vessel. Therefore, this research suggests that flow vorticity is relevant in assessing the risk for CAD, potentially improving the accuracy of non-invasive, computational diagnosis. Such improvements can also help avoid unnecessary invasive diagnosis methods and minimize risk.

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ASSOCIATION OF ENOS GENE POLYMORPHISMS AS A RISK FACTOR OF CORONARY IN-STENT RESTENOSIS

Annals of the Russian academy of medical sciences ◽

10.15690/vramn796 ◽

2017 ◽

Vol 72 (2) ◽

pp. 120-125

Author(s):

L. M. Ogorodova ◽

K. Y. Rukin ◽

S. I. Vintizenko ◽

I. V. Petrova

Keyword(s):

Coronary Artery Disease ◽

Heart Disease ◽

Coronary Artery ◽

Coronary Arteries ◽

Gene Polymorphisms ◽

No Synthase ◽

Enos Gene ◽

Stent Restenosis ◽

Artery Disease ◽

In Stent Restenosis

Background: In recent years more attention is paid to the methods of interventional treatment of coronary artery disease. However, despite the numerous clinical studies the problem of stent restenosis after interventional procedures remains an important one. The studies of the molecular mechanisms of restenosis of coronary arteries and findings for new genetically determined predictors of restenosis after stenting become vital and essential. The NO-synthase influence on the development of endothelial dysfunction is practically assured, but the studies on the NOS genes' polymorphism effect on the incidence rate of in-stent restenosis are isolated and based on a limited number of clinical observations. The determined facts demonstrate the relevance of the conducted study, the results of which formed a new understanding of the role of NO-synthase genes in the predisposition to hyper-proliferative stents in patients with coronary artery disease. Aims: Set association between the eNOS gene polymorphisms and the risk of restenosis in patients with coronary artery disease hospitalized for coronary restenosis.Materials and methods: We examined 484 patients with the verified diagnosis of the ischemic heart disease who underwent treatment at the unit of atherosclerosis and chronic coronary heart disease of «Cardiology Research Institute». Stenting of coronary arteries was performed in 210 people. The group of a restenosis enrolled 60 patients and the group without restenosis — 150. Genotyping was performed by non-enzymatic technique for isolation of genomic DNA from the venous blood of the surveyed, NOS genes' polymorphisms were detected by polymerase chain reaction (PCR). Results: The established development of in-stent restenosis was associated with the following eNOS gene polymorphisms: VNTR ― in homozygotes for the minor allele (genotype aa) and heterozygotes (genotype ab); 894G/T ― in heterozygotes (the GT genotype) and homozygotes (TT genotype).Conclusions: VNTR and 894G/T polymorphisms of eNOS gene are associated with risk for restenosis and can serve as additional markers for risk of restenosis after coronary stenting.

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The peculiarities of atherosclerotic coronary arteries lesion in patients with coronary artery disease and type 2 diabetes mellitus

Endocrine Abstracts ◽

10.1530/endoabs.32.p423 ◽

2013 ◽

Author(s):

Larysa Zhuravlyova ◽

Nataliia Lopina ◽

Inna Demchenko

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Coronary Artery Disease ◽

Type 2 Diabetes Mellitus ◽

Coronary Artery ◽

Coronary Arteries ◽

Artery Disease

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Gender Differences in Non-Obstructive Coronary Artery Disease

Current Pharmaceutical Design ◽

10.2174/1381612826666201012163845 ◽

2020 ◽

Vol 26 ◽

Author(s):

Maria Bergami ◽

Marialuisa Scarpone ◽

Edina Cenko ◽

Elisa Varotti ◽

Peter Louis Amaduzzi ◽

...

Keyword(s):

Coronary Artery Disease ◽

Gender Differences ◽

Heart Disease ◽

Coronary Artery ◽

Ischemic Heart Disease ◽

Coronary Arteries ◽

Obstructive Coronary Artery Disease ◽

Ischemic Heart ◽

Current Evidence ◽

Artery Disease

: Subjects affected by ischemic heart disease with non-obstructive coronary arteries constitute a population that has received increasing attention over the past two decades. Since the first studies with coronary angiography, female patients have been reported to have non-obstructive coronary artery disease more frequently than their male counterparts, both in stable and acute clinical settings. Although traditionally considered a relatively infrequent and low-risk form of myocardial ischemia, its impact on clinical practice is undeniable, especially when it comes to infarction, where the prognosis is not as benign as previously assumed. Unfortunately, despite increasing awareness, there are still several questions left unanswered regarding diagnosis, risk stratification and treatment. The purpose of this review is to provide a state of the art and an update on current evidence available on gender differences in clinical characteristics, management and prognosis of ischemic heart disease with non-obstructive coronary arteries, both in the acute and stable clinical setting.

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

Current Medical Imaging Formerly Current Medical Imaging Reviews ◽

10.2174/1573405614666180111151623 ◽

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>

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