A Case of Distal Left Main Coronary Stenosis, Worsening Five Months after the Implantation of Stents on Both Left Circumflex Artery and Left Descending Coronary Artery

2013 ◽  
Vol 5 (1) ◽  
pp. 33-38
Author(s):  
Minoru Mitsugi
Keyword(s):  
Coronary Artery ◽  
Coronary Stenosis ◽  
Left Main ◽  
Circumflex Artery ◽  
Left Circumflex Artery

scholarly journals Simultaneous stenting of the left main coronary stem and internal carotid artery in a hemodynamically unstable patient

2011 ◽  
Vol 68 (8) ◽  
pp. 712-715 ◽  
Author(s):  
Dragan Sagic ◽  
Zelimir Antonic ◽  
Milan Stanisic ◽  
Nenad Ilijevski ◽  
Predrag Milojevic ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Carotid Artery ◽  
Carotid Stenting ◽  
Main Stem ◽  
Left Main ◽  
Circumflex Artery ◽  
Left Circumflex Artery ◽  
Unstable Patient ◽  
Left Main Stem ◽  
The Right

Introduction. Combined endovascular interventions on carotid and coronary arteries are rare. Stenting of the unprotected coronary left main stem is a high risk procedure. We presented hemodynamically unstable patient with combined carotid artery and left main stem coronary artery stenting. Case report. A 78-year-old female patient was admitted to our institution for right carotid endaterectomy. The patient had 80% stenosis of the right carotid artery and occlusion of the left carotid artery. Coronary angiography revealed 70% ostial left main stenosis, occlusion of the right coronary artery and the left circumflex artery, and 80% stenosis of the left anterior descending artery. Simultaneous carotid artery endaterectomy and coronary artery by-pass grafting were considered. Due to high perioperative risk, surgery was rejected, and the patient was treated endovascularly with stenting of arteries occluded. The procedure was completed without complications and the patient was hemodynamically stabilised. Conclusion. This report illustrates simultaneous coronary and carotid stenting as a successfull lifesaving procedure.

scholarly journals Analiza izvajanja perkutanih koronarnih posegov v 10-letnem obdobju (2005–2015) – izkušnje enega centra

2017 ◽  
Vol 86 (3-4) ◽  
Author(s):  
Ana Reschner ◽  
Maja Rojko ◽  
Hrvoje Reschner ◽  
Igor Zupan ◽  
Andrej Cijan ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Confidence Interval ◽  
Heart Surgery ◽  
Stable Coronary Artery Disease ◽  
Open Heart Surgery ◽  
Left Main ◽  
Circumflex Artery ◽  
Femoral Access ◽  
Left Circumflex Artery ◽  
Cardiovascular Center

Background: Medicor was established as the third cardiovascular center in Slovenia and started with percutaneous cardiovascular interventions in 2005. The purpose of our study was to describe the features and results of percutaneous coronary intervention (PCI) performed between 2005 and 2015.Methods: Our retrospective descriptive study included consecutive patients undergoing PCI, who were enrolled in the PCI Registry. Patient characteristics, coronary anatomy, PCI features, use of coronary stents, procedural success and complications were investigated. Special emphasis was put on patients undergoing unprotected left main PCI.Results: During the study period, 1981 PCI procedures were performed. PCI patients were mainly men (73 %), their average age was 65+10 years and a majority (94 %) had stable coronary disease with mutivessel involvement (62 %). PCI was performed on 2978 lesions (1.50 lesion/patient) with an average diameter stenosis of 85+10 %. Target lesion was located either in the left anterior descending artery (42.9 %), right coronary artery (32.4 %), left circumflex artery (18.4 %), left main (3 %), surgical grafs (2.3 %) or in the intermediate artery (1 %). Balloon angioplasty alone was used in 9.6 % while other patients received 1 to 7 stents (1.44+0.86 per patient). Until 2009, drug eluting stents (DES) penetration ranged between 20 % and 30 %. It then increased to 80 % in 2012 and 100 % in 2015. PCI was angiographically successful in 95.2 %. Because of PCI complications, 4 patients (0.2 %) required immediate open-heart surgery and 4 patients (0.2 %) a surgical intervention at the femoral access site. Hospital mortality was 0 %. Stent thrombosis within 30 days was documented in 6 patients (0.3 %). In a subgroup of 58 patients undergoing unprotected lef main PCI, provisional stenting was used in 88 %. DES penetration was 94 %. PCI was angiografcally successful in all patients. Hospital and 30-day mortality rates were 0 %, 1-year mortality 1.7 % (95 % confidence interval 0–11 %) and 5-year mortality 13.8 % (95 % confidence interval 7–33 %). Target vessel revascularization at 5 years was 3.5 % (95 % confidence interval 0–23 %).Conclusion: PCI in patients with predominantly stable coronary artery disease in the Medicor Cardiovascular Center appears to be an effective and safe method of revascularization, which is also true for an intervention in unprotected left main.

scholarly journals Relationship between neutrophils to HDL-C ratio and severity of coronary stenosis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tuli Kou ◽  
Haorou Luo ◽  
Lixue Yin
Keyword(s):  
Regression Analysis ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Coronary Stenosis ◽  
Independent Predictor ◽  
Control Group ◽  
Circumflex Artery ◽  
Left Circumflex Artery ◽  
Markers Of Inflammation ◽  
Luminal Stenosis

Abstract Background Lipid and inflammatory molecules play a key role in the development of inflammation. Neutrophil counts are used as markers of inflammation duration, and HDL-C is used as an anti-atherosclerosis component. However, few studies have been found to integrate these two indicators to explore coronary stenosis. We suggested that neutrophil count as a marker of inflammation persistence and HDL-C as an anti-atherosclerotic component should be integrated into a single biomarker NHR to explore its correlation with CAD degree and predict the severity of coronary stenosis among CAD patients. Methods We examined 404 eligible patients who underwent coronary angiography. Based on the results of coronary angiography, patients in CAD+ group (n = 155) were defined as those having angiographic coronary stenosis of at least 50% lumen reduction in at least one major coronary artery (including left anterior descending artery, left circumflex artery, left main coronary artery, right coronary artery). Patients with luminal stenosis but no more than 50% were defined as CAD− group (n = 49), and patients without luminal stenosis (n = 200) were regarded as control group. The relationship between various serum markers and the severity of coronary stenosis was examined by Spearman correlation analysis. Logistic regression analysis was performed to identify the influencing factors of the severity of coronary artery disease. Results The modified Gensini score was positively correlated with neutrophil HDL-C ratio and negatively correlated with albumin and HDL-C. Multiple regression analysis showed that neutrophil HDL-C ratio were significantly associated with CAD. Neutrophil HDL-C ratio is an independent predictor of CAD. The ROC analysis provided a cut-off value of 1.51 for neutrophil HDL-C ratio to predict CAD with 94.8% sensitivity and 0.024 Yoden index, and area under the ROC curve of 0.617 (95% CI 0.560–0.675, P < 0.001). Conclusion Neutrophil HDL-C ratio is not only closely related to coronary artery stenosis, but also an independent predictor of severe coronary stenosis.

scholarly journals Single-stent crossover technique from distal unprotected left main coronary artery to the left circumflex artery

2013 ◽  
Vol 34 (suppl 1) ◽  
pp. P1244-P1244
Author(s):  
T. Naganuma ◽  
A. Chieffo ◽  
S. Basavarajaiah ◽  
K. Takagi ◽  
C. Costopoulos ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Left Main Coronary Artery ◽  
Left Main ◽  
Circumflex Artery ◽  
Left Circumflex Artery

scholarly journals A case report of successful complex percutaneous coronary intervention for acute coronary syndrome in a paediatric patient with familial hypercholesterolaemia

2021 ◽  
Vol 5 (6) ◽  
Author(s):  
Mrunmayee Deshpande ◽  
Milind Phadke ◽  
Talha Khan Abid ◽  
Ajay U Mahajan
Keyword(s):  
Coronary Artery ◽  
Left Main Coronary Artery ◽  
Coronary Intervention ◽  
Left Main ◽  
Circumflex Artery ◽  
Left Circumflex Artery ◽  
Coronary Syndrome ◽  
Percutaneous Coronary ◽  
Symptomatic Coronary Artery Disease ◽  
Artery Disease

Abstract Background Familial hypercholesterolaemia (FH) is a primary genetic dyslipidaemia characterized by elevation in serum low-density lipoprotein cholesterol and its deposition in systemic arteries, which causes premature atherosclerosis. Case summary A 10-year-old girl presented with severe symptomatic coronary artery disease. She demonstrated characteristic morphological features of FH. Despite aggressive medical management and lipid-lowering therapy, her symptoms were not relieved and she had dynamic electrocardiogram changes. Coronary angiography showed a distal left main coronary artery lesion along with significant lesions in ostio-proximal and mid-left circumflex artery which were managed by provisional left main coronary artery to left circumflex artery stenting technique, with good immediate- and short-term results and angina relief. Discussion To the best of our knowledge, this is the first reported case of a paediatric patient with FH and acute coronary syndrome treated with percutaneous coronary intervention to left main coronary artery and left circumflex artery using provisional stenting technique. Revascularization strategies for symptomatic coronary artery disease in paediatric patients with FH have multiple unique challenges and remain an unexplored and under-reported subject.

scholarly journals Dissection of ascending aorta and left main coronary artery after routine percutaneous coronary intervention: a case report

2019 ◽  
Vol 3 (Issue 4) ◽  
pp. 184
Author(s):  
B.S. Daniyarov ◽  
I.Z. Abdyldaev ◽  
S.D. Chevgun ◽  
K.N. Nurbekov ◽  
D. Ch. Cholponbaev ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Left Main Coronary Artery ◽  
Artery Bypass ◽  
Ascending Aorta ◽  
Left Main ◽  
Circumflex Artery ◽  
Total Occlusion ◽  
Catheterization Laboratory ◽  
Left Circumflex Artery ◽  
Left Anterior Descending Artery

We describe a case of guiding catheter induced dissection of left main coronary artery and ascending aorta. A patient with unstable angina and two-vessel disease underwent drug eluting stents implantation in proximal left anterior descending artery and distal left circumflex artery. Six hours after the procedure of acute occlusive dissection of left main coronary artery with spreading to ascending aorta developed, it was required to do stenting of the left anterior descending and left main coronary arteries and balloon dilatation of left circumflex artery. Despite the initial success of the repeated intervention, total occlusion of left main coronary artery occurred with unsuccessful reopening in catheterization laboratory. Emergency coronary artery bypass surgery was carried out. However, despite the patent anastomosis from left mammary to left anterior descending artery, the patient died.

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.

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