Successful endovascular extraction of newer generation Angio-Seal collagen plug and anchor after acute embolization

Vascular ◽  
2013 ◽  
Vol 22 (3) ◽  
pp. 214-217 ◽  
Author(s):  
Nidal Abi Rafeh ◽  
Faisal B Saiful ◽  
Georges Khoueiry ◽  
Mohammad Zgheib ◽  
Salman Arain
Keyword(s):  
Coronary Bypass ◽  
Coronary Intervention ◽  
Drug Eluting Stent ◽  
Closure Device ◽  
Circumflex Artery ◽  
Left Circumflex Artery ◽  
Vascular Laboratory ◽  
History Of ◽  
Drug Eluting ◽  
The Right

A 75-year-old woman with past medical history of coronary bypass, atrial fibrillation, mitral valve repair undergoes percutaneous coronary intervention of left circumflex artery with a drug eluting stent. An Angio-Seal vascular closure device was used post procedure to obtain hemostasis. Shortly after deployment, frank bleeding was observed necessitating manual compression at the arteriotomy site. After hemostasis was achieved, the right lower extremity was found to be pale, bluish with feeble pulses. Doppler ultrasound was emergently performed revealing decreased blood flow after mid superficial femoral artery (SFA) and an echo lucent object lodged luminally in the SFA. Patient was urgently taken to the vascular laboratory where an Angio-Seal device, including the collagen plug and anchor, was successfully removed endovascularly patient made full recovery and was discharged home the following day.

P971Impact of treatment strategy on 1-year outcome for Left Main trifurcation lesions

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
K Tani ◽  
S Mitomo ◽  
K Tanaka ◽  
S Tahara ◽  
S Nakamura
Keyword(s):  
Clinical Outcomes ◽  
Coronary Intervention ◽  
Drug Eluting Stent ◽  
Restenosis Rate ◽  
Left Main ◽  
Circumflex Artery ◽  
Left Circumflex Artery ◽  
Significant Difference ◽  
Drug Eluting

Abstract Background/Introduction Limited data exist regarding procedural strategy and clinical outcomes after percutaneous coronary intervention (PCI) for unprotected left main (LM) trifurcation lesion. Purpose The aim of this study is to evaluate 1-year clinical outcomes after LM trifurcation PCI comparing different strategies in kissing balloon inflation (KBI). Methods From 1, January, 2011 to 31, March, 2017, patients who underwent LM trifurcation PCI with second generation drug-eluting stent in our center were retrospectively analyzed. They were categorized into single-stent KBT group (KBT in left anterior descending artery [LAD] and left circumflex artery [LCX], or LAD and high lateral branch [HL]) and no-KBT group. Primary endpoint is restenosis in the lesions. Results Among 1301 patients who underwent LM PCI during the study period, 163 patients (12.5%) had a trifurcation lesion. Regarding the number of stents used for the lesions, 1, 2 and 3 stents were used in 75.4%, 22.0% and 2.5%, respectively. Median follow-up period of LM trifurcation patients was 265 days (interquartile range: 81–564). In the no-KBT group (64 patients), 19 patients experienced restenosis of HL and LCX (HL: 8 patients, LCX: 0 patient, and both: 11 patients). In the KBT-group, KBT for LAD and LCX was performed in 47 patients, and of them, 19 patients experienced restenosis of LM-LAD, HL and LCX (HL: 12 patients, LCX: 6 patients and all: 1 patient). On the other hand, in 9 patients with KBT for LAD and HL, there were no restenosis cases at 1-year follow-up. There was no statistically significant difference in restenosis rate between the no-KBI and KBT group (29.6% vs. 40.4%, p=0.69). Restenosis rates in each segments Conclusion After LM trifurcation PCI, restenosis rate at 1-year follow-up was high, and no difference between no-KBT and KBT group overall. However, there was no restenosis case in patients with KBT for LAD and HL.

scholarly journals A case of left circumflex artery stenosis involving ST segment depression in multiple leads with ST elevation in lead augmented vector right

2019 ◽  
Vol 6 (7) ◽  
pp. 2598
Author(s):  
C. P. Karunadas ◽  
Cibu Mathew
Keyword(s):  
Beta Blockers ◽  
Coronary Intervention ◽  
Drug Eluting Stent ◽  
Circumflex Artery ◽  
St Segment Elevation ◽  
Left Circumflex Artery ◽  
St Depression ◽  
St Segment ◽  
Lead Avr ◽  
St Elevation

Electrocardiography (ECG) patterns of ST-segment elevation in lead aVR with or without diffuse ST segment depression may predict either left main coronary artery or triple vessel stenosis. Here, we have presented the case of a 56-year-old female involving such an ECG pattern with ST-segment depression in more than eight leads and ST Segment elevation in lead aVR, however, showing stenosis of the mid-segment of the left circumflex artery (LCX). She was scheduled to undergo percutaneous coronary intervention with implantation of a drug-eluting stent with respect to mid LCX stenosis. The patient was asymptomatic post procedure and was discharged on beta blockers. To conclude, the ECG pattern of ST depression in multiple leads with ST-elevation in aVR lead can occur in LCX obstruction as well. 

scholarly journals Successful drug-eluting stent implantation in a male patient with dextrocardia: a case report

Open Medicine ◽  
2017 ◽  
Vol 12 (1) ◽  
pp. 481-484 ◽  
Author(s):  
Wenjie Long ◽  
Zhiling He ◽  
Xia Wang ◽  
Huanlin Wu ◽  
Yahui Chen ◽  
...  
Keyword(s):  
Situs Inversus ◽  
Rare Condition ◽  
Coronary Intervention ◽  
Mirror Image ◽  
The Body ◽  
Drug Eluting Stent ◽  
Complete Transposition ◽  
General Rules ◽  
Drug Eluting ◽  
The Right

AbstractSitus inversus with dextrocardia is a rare condition, with complete transposition of all the body organs, including the heart. Percutaneous coronary intervention (PCI) in these patients is technically difficult because of the mirror image of organs. Here, we describe a 56-year-old man with coronary heart disease with known situs inversus with dextrocardia and coronary percutaneous intervention was performed for stenosis in the right coronary artery. A drug eluting stent was implanted at this site successfully. This case suggested that the interventional management of such patients follows the same general rules as for non-dextrocardia patients, but the manipulation of the catheter and projection position choices need to be taken into consideration to obtain optimal benefits for the patient.

scholarly journals Distal embolization of coronary calcified nodule after rotational atherectomy

2018 ◽  
Vol 6 ◽  
pp. 2050313X1879924 ◽  
Author(s):  
Norihiro Kobayashi ◽  
Yoshiaki Ito ◽  
Masahiro Yamawaki ◽  
Motoharu Araki ◽  
Tsuyoshi Sakai ◽  
...  
Keyword(s):  
Coronary Intervention ◽  
Target Lesion ◽  
Rotational Atherectomy ◽  
Drug Eluting Stent ◽  
Distal Embolization ◽  
Burr Size ◽  
Stent Expansion ◽  
Percutaneous Coronary ◽  
Drug Eluting ◽  
The Right

A 62-year-old man with effort angina underwent percutaneous coronary intervention in our hospital. The target lesion was severely calcified at the mid part of the right coronary artery. Pre-procedural intravascular imaging and optical frequency domain imaging showed a calcified nodule at the lesion. We performed rotational atherectomy with a 2.0 mm burr and observed an increase in the lumen area; however, a large amount of calcified nodule persisted. We decided to perform rotational atherectomy with a burr size of 2.25 mm; however, distal embolization of the calcified nodule occurred. We failed to retrieve the embolus; hence, we performed balloon dilatation with a 2.0-mm balloon, which was successfully performed. Yet, the lesion with the embolus immediately recoiled. Finally, a drug-eluting stent was implanted in both the distal lesion with the embolus and the lesion with the calcified nodule. Final coronary angiography showed good results. We confirmed good stent expansion and that calcified nodule was compressed outside the stent. Atherectomy of a calcified nodule is effective at achieving sufficient stent expansion and reducing the risk of vessel perforation. However, we experienced distal embolization of the calcified nodule at the time of rotational atherectomy and so distal embolization should be considered at the time of treatment of calcified nodule.

Abstract 141: A Case of Kawasaki Disease with Re-dilatation of a Coronary Artery Aneurysm after Regression

Circulation ◽  
2015 ◽  
Vol 131 (suppl_2) ◽  
Author(s):  
Kensuke Oka ◽  
Takaomi Minami ◽  
Tatsuya Anzai ◽  
Sadahiro Furui ◽  
Akiko Yokomizo ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Kawasaki Disease ◽  
Coronary Angiography ◽  
Artery Aneurysm ◽  
Circumflex Artery ◽  
Left Circumflex Artery ◽  
Coronary Ct ◽  
History Of ◽  
The Right

Background: In patients with Kawasaki disease (KD), re-dilatation of coronary artery lesions (CAL) after regression is very rare. Here we report a case of KD with CAL re-dilatation after regression. Case report: A 15-year-old boy was diagnosed with KD at 1 year of age and was treated with intravenous immunoglobulin (IVIG, 400 mg/kg х 5 days). On day 14, echocardiography revealed CAL on the right coronary artery (RCA) and left coronary artery (LCA). Coronary arteriographic findings were as follows: segment 1, 3 mm in diameter; segment 6, 5 mm in diameter. He was prescribed aspirin, ticlopidine, and warfarin for 3 years. When he was 3 years old, coronary angiography showed complete CAL regression. His medications were discontinued and he underwent routine follow-up by echocardiography on which the CAL were not seen. At 14 years of age, coronary CT revealed re-dilatation of the LCA. Coronary angiography showed the same findings: 7 mm in diameter at the bifurcation between the LAD and the left circumflex artery, while the other regions were intact. He restarted aspirin and warfarin. The mechanism of CAL re-dilatation remains unclear; however, it is very important to follow patients carefully and routinely using echocardiography and/or coronary computed tomography, especially in cases with a history of CAL.

Cangrelor Bridge Therapy for Gastroduodenal Biopsy

2016 ◽  
Vol 30 (2) ◽  
pp. 270-273 ◽  
Author(s):  
William D. Cahoon ◽  
Allison K. Oswalt ◽  
Kerry E. Francis ◽  
Lauren C. Magee ◽  
Denise K. Lowe
Keyword(s):  
Coronary Intervention ◽  
Drug Eluting Stent ◽  
Bridging Therapy ◽  
Percutaneous Coronary ◽  
History Of ◽  
Drug Eluting ◽  
Coronary Syndromes ◽  
Bridge Therapy ◽  
Ischemic Events ◽  
Gastroduodenal Biopsy

Dual antiplatelet therapy (DAPT) is the key for secondary prevention of acute coronary syndromes and percutaneous coronary intervention with stent placement. Premature discontinuation of DAPT can result in an increase in cardiac ischemic events and death. If early interruption of DAPT for urgent procedures or surgery is necessary, then ischemic and bleed risks must be balanced with bridging therapy. To date, no medications have a Food and Drug Administration indication for antiplatelet bridge therapy. We present a case of a woman with a history of gastrointestinal bleeding on DAPT for a drug-eluting stent who received cangrelor as bridge therapy prior to gastroduodenal biopsy.

scholarly journals A Case Summary of the Application of a Drug-Eluting Stent Combined with a Drug-Coated Balloon in Left Main Coronary Artery Disease

2021 ◽  
Author(s):  
Jun-Qing Gao
Keyword(s):  
Coronary Artery ◽  
Left Main Coronary Artery ◽  
Drug Eluting Stent ◽  
Restenosis Rate ◽  
Left Main ◽  
Circumflex Artery ◽  
Left Circumflex Artery ◽  
Clinical Events ◽  
Drug Eluting ◽  
Drug Coated Balloon

Objective: To evaluate the clinical efficacy of a drug-eluting stent (DES) combined with a drug-coated balloon (DCB)in the treatment of left main coronary artery bifurcation lesions.Methods: A retrospective analysis was conducted on the clinical data of eight patients with left main coronary arterybifurcation lesions treated with a DES combined with a DCB who were admitted to our hospital from July 2016 to July2017. These eight patients all underwent DES treatment for their left main coronary artery and left anterior descendingcoronary artery lesions, and DCB treatment at the ostium of the left circumflex artery; six of the patients underwentsurgical procedures under the guidance of intravascular ultrasonography. Immediate postoperative angiography wasused to evaluate the patency of the diseased vessels, and the restenosis rate at the 6-month follow-up after the operationand the incidence of serious clinical events within 6 months were assessed as well.Results: The use of a DES combined with a DCB in the treatment of left main coronary artery bifurcation lesions hada low restenosis rate (left main coronary artery (8.4 ± 5.3)%, left anterior descending coronary artery (18.2 ± 5.0)%,left circumflex artery (30.5 ± 16.5)%). No serious clinical events occurred in any patients.Conclusion: A DES combined with a DCB is a safe and effective interventional treatment for left main artery coronarybifurcation lesions.

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.

Sign in / Sign up

Export Citation Format

Share Document