The rotational atherectomy with a guide extension catheter for calcified and tortuous lesions in left anterior descending artery: a case report

Abstract Background The interventional treatment of calcified lesions with severe tortuosity in the left anterior descending artery (LAD) was challenging and the report of rotational atherectomy with mother-and-child technique has been scarce. Case presentation An 84-year-old woman was hospitalized for non-ST-segment acute coronary syndrome. Coronary angiography revealed a calcified nodule in the LAD. During rotational atherectomy of the calcified and tortuous lesion in the proximal LAD, eccentric cutting due to wire bias nearly caused perforation. The burr seemed to protrude from the contrast media during angiography. Intravascular ultrasound imaging revealed that extremely eccentric ablation almost reached the adventitia. We successfully ablated the distal calcified nodule by preventing proximal overcutting of the tortuous lesion with support from a guide extension catheter, i.e., the mother-and-child technique, followed by the deployment of the drug-eluting stent. The patient was discharged without chest symptoms and no symptom recurred during 12-month follow-up. Conclusion This case demonstrated that safe ablation of a calcified nodule located distal to a tortuous and calcified lesion in the proximal LAD with the mother-and-child technique.

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Multivessel vs Single-Vessel Revascularization in Patients With Non-ST-Segment Elevation Acute Coronary Syndrome and Multivessel Disease in the Drug-Eluting Stent Era

Clinical Cardiology ◽

10.1002/clc.20858 ◽

2011 ◽

Vol 34 (3) ◽

pp. 160-165 ◽

Cited By ~ 22

Author(s):

Hyun Jong Lee ◽

Young Bin Song ◽

Joo-Yong Hahn ◽

Sang Min Kim ◽

Ji Hyun Yang ◽

...

Keyword(s):

Acute Coronary Syndrome ◽

Multivessel Disease ◽

Drug Eluting Stent ◽

St Segment Elevation ◽

Coronary Syndrome ◽

Single Vessel ◽

St Segment ◽

Drug Eluting ◽

Elevation Acute Coronary Syndrome

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Late thrombosis of coronary bare-metal stent: Case report

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh0604155a ◽

2006 ◽

Vol 134 (3-4) ◽

pp. 155-158 ◽

Cited By ~ 1

Author(s):

Svetlana Apostolovic ◽

Zoran Perisic ◽

Miloje Tomasevic ◽

Goran Stankovic ◽

Milan Pavlovic ◽

...

Keyword(s):

Stent Thrombosis ◽

Bare Metal Stent ◽

Drug Eluting Stent ◽

Bare Metal ◽

Metal Stent ◽

Coronary Syndrome ◽

Percutaneous Coronary ◽

Drug Eluting ◽

Late Thrombosis ◽

And Control

Stent thrombosis remains the primary cause of death after percutaneous coronary interventions (PCI). Despite modern concepts of PCI, stent thrombosis occurs in 0.5% -2% of elective procedures and even 6% of patients with the acute coronary syndrome (ACS). Stent thrombosis most often develops within the first 48 hours after the PCI, and rarely after a week of stent implantation. Angiographically documented late (>6 months) thrombosis of coronary bare-metal stent (BMS) is rare, because the stent endothelialization is considered to be completed after four weeks of the intervention. Our patient is a 41 year old male and he had BMS thrombosis 345 days after the implantation, which was clinically manifested as an acute myocardial infarction in the inferoposterolateral localization. Stent Clinical Centre of Serbia, Belgrade thrombosis occurred despite a long term dual antiplatelet therapy and control of known risk factors. Thrombolytic therapy (Streptokinase in a dose of 1 500 000 IU) was not successful in reopening the occluded vessel, so the flow through the coronary artery was achieved by rescue balloon angioplasty, followed by implantation of drug eluting stent in order to prevent restenosis.

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Endovascular Treatment with Limus Eluting Stents in Patients with Acute Coronary Syndrome

Russian Sklifosovsky Journal Emergency Medical Care ◽

10.23934/2223-9022-2019-8-1-45-52 ◽

2019 ◽

Vol 8 (1) ◽

pp. 45-52

Author(s):

M. V. Chernyayev ◽

A. G. Faybushevich ◽

Y. S. Muzganova

Keyword(s):

Coronary Heart Disease ◽

Acute Coronary Syndrome ◽

Heart Disease ◽

Drug Therapy ◽

Fatal Outcome ◽

Drug Eluting Stent ◽

Health State ◽

Medium Term ◽

Coronary Syndrome ◽

Drug Eluting

BACKGROUND Coronary heart disease is one of the main causes of the population’s disability and mortality in Russia and abroad. Revascularization with coronary stents in the course of the most suitable drug therapy is one of the most important treatments of coronary heart disease. It is essential to pay special attention to the research results of using modern stents, in particular, the frst Russian drug-eluting stent “CALYPSO”.AIM OF STUDY To study immediate and medium-term results of Limus-eluting stents procedure in patients with acute coronary syndrome.MATERIAL AND METHODS 304 patients with acute coronary syndrome were included into the research and were divided into 2 groups. The frst group consisted of 156 patients with CALYPSO stent (Angioline, Russia). The other group consisted of 148 patients who had undergone revascularization with the XIENCE stent (Abbot Vascular, USA). Their health state was monitored via phone 3, 6, 9 and 12 months later. After the discharge from the hospital, the drug therapy was prescribed, and instrumental procedures of diagnostics were planned for the period of 9–12 months. According to the results of the examination, patients with suspected or confrmed myocardial ischemia underwent follow-up coronary angiography.RESULTS The success of implantation was 98.63% in the frst group, and 99.4% in the second group. One fatal outcome occurred in both groups during hospitalization (thus making 0.64% и 0.67%). The placement of the CALYPSO stent in distal parts of coronary arteries requested signifcantly less time and contrast. Medium-term results of stenting in both groups appeared to be comparable (thus, all cause death 3 (1.92%) and 2 (1.35%), restenosis >50% 3 (1.92%) and 3 (2 %), late thrombosis — 0 in both groups, cardiac death — 0 in both groups. End points (MACE) in both groups were 1.28% and 0.67%.CONCLUSION Taking into consideration immediate and medium-term results it can be concluded that domestic stents (CALYPSO) are comparable to stents XIENCE. The CALYPSO stent is more advantageous than the XIENCE in the delivery to the lesion focus while performing the procedure in distal ﬂow.

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