scholarly journals Central Vascular Complications Following Elective Catheterization Using Transradial Percutaneous Coronary Intervention

2017 ◽  
Vol 5 (1) ◽  
pp. 232470961769871 ◽  
Author(s):  
Julia Merkle ◽  
Christopher Hohmann ◽  
Anton Sabashnikov ◽  
Thorsten Wahlers ◽  
Jens Wippermann
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Vascular Complications ◽  
Coronary Intervention ◽  
Artery Dissection ◽  
Case Presentation ◽  
Transradial Approach ◽  
Percutaneous Coronary ◽  
Artery Disease ◽  
The Right ◽  
Transradial Catheterization

Percutaneous coronary intervention is commonly used to treat coronary artery disease. Both transradial and transfemoral approaches are applied. In general, fewer complications are seen with the transradial approach compared to the transfemoral access, for which reason the transradial catheterization is frequently preferred. In this case presentation, we describe 2 cases of elective transradial coronary angiography both resulting in severe central vascular complications: perforation of the right subclavian artery with a mediastinal hematoma and dissection of the brachio-cephalic trunk and the aortic arch. Although the transradial access is generally considered safe, severe complications such as artery dissection or perforation can occur even in cases of elective procedures.

scholarly journals Multi-Vessel Coronary Artery Disease: Choice of Myocardial Revascularization Strategy

2020 ◽  
Vol 27 (4) ◽  
pp. E202041
Author(s):  
Nestor Seredyuk ◽  
Andrii Matlakh ◽  
Yaroslava Vandzhura ◽  
Mykyta Bielinskyi ◽  
Oleksii Skakun ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Right Coronary Artery ◽  
Myocardial Revascularization ◽  
Coronary Intervention ◽  
Percutaneous Coronary ◽  
Artery Disease ◽  
The Right

Multi-vessel coronary artery disease is quite a common state, which is often diagnosed by coronary angiography in patients with both stable coronary artery disease and acute coronary syndromes. Major difficulties in percutaneous coronary intervention include stent thrombosis and the need for antiplatelet therapy (aspirin and a P2Y12 inhibitor). Stent thrombosis leads to the recurrence of myocardial infarction and may occur within the first few hours after percutaneous coronary intervention. The use of dual antiplatelet therapy, especially that combined with low-molecular-weight heparin in the first days after myocardial infarction, poses a risk of bleeding, which often occurs in real clinical practice. Among P2Y12  inhibitors, ticagrelor causes bleeding somewhat more frequently than clopidogrel. A case of multi-vessel coronary artery disease is described in this paper. Coronary angiography revealed right-dominant circulation; occlusion of the proximal and medial segments of the right coronary artery, thrombolysis in myocardial infarction flow grade 0; stenosis of the left main coronary artery (50-60%), thrombolysis in myocardial infarction flow grade 2; diffuse stenosis of the medial and distal segments of the left anterior descending artery, thrombolysis in myocardial infarction flow grade 1; stenosis of the proximal segment of the left circumflex artery (> 75%), thrombolysis in myocardial infarction flow grade 1. The patient underwent percutaneous coronary intervention; the stents were implanted in the infarct-dependent right coronary artery. The clinical course was complicated by early stent thrombosis with subsequent thrombus extraction; a day later melena developed. Bleeding was stopped, the intensity of antithrombotic therapy was reduced: the combination of aspirin and ticagrelor was replaced by the combination of aspirin and clopidogrel. Six weeks after stenting of the infarct-dependent coronary artery, complete myocardial revascularization (hybrid intervention) was performed: coronary artery bypass grafting [the left internal mammary artery → the left anterior descending artery], coronary autogenous bypass grafting [the aorta → the right coronary artery and the aorta → the left circumflex artery]. The role of fractional flow reserve or instantaneous wave-free ratio-controlled complete myocardial revascularization techniques is discussed. The following algorithm for myocardial revascularization was used: percutaneous coronary intervention for the right coronary artery + coronary artery bypass grafting-3: the left internal mammary artery → the left anterior descending artery, the aorta → the left circumflex artery, the aorta → the right coronary artery.

scholarly journals Iatrogenic Dissection of The Right Coronary Artery and The Ascending Aorta Secondary to Percutaneous Coronary Intervention: A Case Report

2020 ◽  
Vol 23 (3) ◽  
pp. E366-E369
Author(s):  
Changjiang Yu ◽  
Fan He ◽  
Huaidong Chen ◽  
Jianmao Hong ◽  
Ximing Qian
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Right Coronary Artery ◽  
Coronary Intervention ◽  
Ascending Aorta ◽  
Artery Dissection ◽  
Coronary Artery Dissection ◽  
Percutaneous Coronary ◽  
Aorta Replacement ◽  
The Right

Iatrogenic dissections of coronary artery and aorta is a rare and potentially fatal event, often following percutaneous coronary intervention (PCI). The prognosis of patients often depends on early accurate diagnosis and timely and effective treatment. There are no definite guidelines for the treatment of acute coronary artery dissection caused by PCI. Here, we report a 50-year-old patient with iatrogenic dissection of the right coronary artery and type A aortic dissection who underwent PCI for chest pain. We performed emergency surgery of right coronary artery ostium repair, aortic valvoplasty, ascending aorta replacement, and aortic arch descending stent implantation for the patient. The operation went smoothly, and the patient successfully was discharged two weeks after the operation.

scholarly journals Coronary Artery Dissection and Perforation Complicating Percutaneous Coronary Intervention – A Review

1970 ◽  
Vol 3 (2) ◽  
pp. 239-247 ◽  
Author(s):  
Z Rahman ◽  
M Ullah ◽  
AK Choudhury
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Coronary Intervention ◽  
Artery Dissection ◽  
Covered Stents ◽  
Coronary Artery Dissection ◽  
Percutaneous Coronary ◽  
Interventional Devices ◽  
Life Threatening ◽  
Artery Disease

After its introduction by Andrew R. Gruentzig in 1977 percutaneous coronary intervention (PCI) is widely utilized in the treatment of symptomatic coronary artery disease. Though it has numerous benefits, serious and potentially life-threatening complications of PCI can occur, including iatrogenic coronary artery dissection and perforation. The incidence of these complications has been augmented by the development of coronary interventional devices intended to remove or ablate tissue. Here we review the classification, incidence, pathogenesis, clinical sequelae and management of coronary artery dissection and perforation in the current era due to PCI. Specifically, the current angiographic classifications of coronary artery dissections and perforations are reviewed. The findings of several recent, registries of PCI-related coronary artery perforations and dissection are summarized. The management of coronary artery dissection and perforation is discussed in details, including the application of newer modalities such as covered stents. Keywords: Percutaneous coronary intervention (PCI); Coronary artery dissection DOI: http://dx.doi.org/10.3329/cardio.v3i2.9198   Cardiovasc. J. 2011; 3(2): 239-247

scholarly journals Conservative Treatment of Iatrogenic Ascending Aortic Hematoma Post-Rotablator Coronary Procedure

2020 ◽  
Vol 09 (01) ◽  
pp. e47-e50
Author(s):  
Maxime Doutriaux ◽  
Benjamin Pariente ◽  
Jad Zahnan ◽  
Xavier Marchand
Keyword(s):  
Conservative Treatment ◽  
Intramural Hematoma ◽  
Coronary Intervention ◽  
Artery Dissection ◽  
Coronary Artery Dissection ◽  
Case Presentation ◽  
Percutaneous Coronary ◽  
Coronary Procedure ◽  
The Right ◽  
Aortic Intramural Hematoma

Abstract Background Aortic intramural hematoma due to coronary artery dissection is a rare and serious complication during percutaneous coronary intervention. Case Presentation A 78-year-old female patient was admitted for diagnostic coronarography in the context of stable angina. The coronarography showed an asymmetric and significate calcification in the ostium of the right coronary requiring Rotablator (Boston Scientific) procedure complicated by iatrogenic ascending aortic hematoma. After surgical advice, a conservative approach was decided with total hematoma resorption and recovery 1 week later. Conclusion With stable patient, conservative treatment may be suitable after aortic hematoma due to coronary dissection.

scholarly journals Robotic-Assisted Percutaneous Coronary Intervention Through Transradial Approach: Experience in 4 Patients with Complex Lesions

2020 ◽  
Vol 47 (2) ◽  
pp. 144-148
Author(s):  
Amornpol Anuwatworn ◽  
Muhammad Ali Kahn ◽  
Tomasz Stys ◽  
Marian Petrasko ◽  
Adam Stys
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Coronary Intervention ◽  
Transfemoral Approach ◽  
Transradial Approach ◽  
Robotic Assisted ◽  
Diagonal Branch ◽  
Percutaneous Coronary ◽  
The Right ◽  
Complex Lesions

Robotic-assisted percutaneous coronary intervention can reduce the exposure of interventional cardiologists to radiation and minimize the risk of occupational orthopedic injuries from wearing heavy protective aprons. The PRECISE (Percutaneous Robotically-Enhanced Coronary Intervention) study showed the efficacy and safety of robotic-assisted procedures for relatively low-risk lesions in single coronary arteries. Several reports have described robotic-assisted treatment of complex high-risk lesions, mostly through the transfemoral approach. We report 4 cases of patients in whom we used the transradial approach to treat complex lesions in the left anterior descending coronary artery with bifurcation balloon angioplasty reconstruction (2 cases), in the ostium of the first diagonal branch, and in the right coronary artery.

Sign in / Sign up

Export Citation Format

Share Document