scholarly journals Unnecessary PCI Attempt for Presumed CTO Which Was Revealed To Be Anomalous Coronary Arteries – Role of Coronary CT Angiography

2020 ◽  
Vol 23 (5) ◽  
pp. E665-E667
Author(s):  
Hyungdon Kook ◽  
Jin-Ho Choi ◽  
Hyun Jong Lee ◽  
Cheol Woong Yu
Keyword(s):  
Coronary Artery ◽  
Coronary Arteries ◽  
Right Coronary Artery ◽  
Chronic Total Occlusion ◽  
Coronary Intervention ◽  
Total Occlusion ◽  
Percutaneous Coronary ◽  
The Right ◽  
Anomalous Coronary ◽  
Anomalous Coronary Arteries

Herein, we present a brief case of anomalous coronary arteries mistaken to be chronic total occlusion. Since we first presumed the anomalous coronary arteries to be chronic total occlusion of the distal right coronary artery, percutaneous coronary intervention was attempted for the presumed lesion, but it failed. Before the second attempt of percutaneous coronary intervention, coronary computed tomography angiography revealed the coronary artery from the left anterior descending artery corresponding with the distal part of the right coronary artery without connection to the right coronary artery. Therefore, we recognized the patient had anomalous coronary arteries with no connection of the vascular wall between the main and distal segments of the right coronary artery. This case may give insights to the importance of meticulous examination of coronary computed tomography angiography imaging before chronic total occlusion percutaneous coronary intervention to avoid the unnecessary procedure.

Dose All of the Coronary Fistulas been Created by the Reopening Wire After Successful Revascularization of Chronic Total Occlusion?

2020 ◽  
Author(s):  
Rong Fan ◽  
Haipeng Tan ◽  
Yanan Song ◽  
Wang Yao ◽  
Yawei Yang ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Right Coronary Artery ◽  
Chronic Total Occlusion ◽  
Coronary Intervention ◽  
Complete Revascularization ◽  
Total Occlusion ◽  
Left Anterior Descending Artery ◽  
Percutaneous Coronary ◽  
History Of ◽  
The Right

Abstract Background: Coronary fistulas may be congenital or acquired generally as consequence of coronary interventions, mainly chronic total occlusion (CTO) reopening. When the reopening wire passes through the occlusion it may microperforate the advential vascular layers, favoring the fistulous communication between coronary vessel and cardiac chambers. But some of acquired coronary fistulas (ACFs) had been already present at the CTO vessels and would been seen after revascularization. This study was designed to investigate the characteristics of ACFs, which albeit mostly benign can cause concern and unnecessary treatment post successful CTO percutaneous coronary intervention (PCI).Methods: Data, including clinical and procedural characteristics, medical history, and findings in electrocardiography, echocardiography and coronary angiography, from 2169 consecutive patients undergoing CTO PCI between January 2018 and December 2019 were analyzed retrospectively. Results: 1844 (85.0%) underwent successful CTO PCI with complete revascularization. Among them, there were 49 cases (mean age, 62.80 ± 11.24 years; 40 men) of ACFs: 24 (49%) involved the right coronary artery, 19 (38.8%) the left anterior descending artery, and 6 (12.2%) the circumflex branch; and 38 (77.6%) were coupled with multiple fistulas (>3), and 29 (59.2%) affected multiple branches of the CTO vessel (>3). The majority of patients with ACFs had a history of MI or Q-wave (n=34, 69.4%), and angina was the most common complaint (n=41, 83.7%). None of them had pericardial effusion, tamponade and Hemodynamic abnormalities before or after PCI.Conclusion: ACFs after successful CTO PCI mostly developed in patients with MI history, originated from the right coronary artery or left anterior descending artery, and involved multiple fistulas and CTO vessel branches.

scholarly journals Successful Rotational Atherectomy for an Angulated Calcified Lesion in an Anomalous Right Coronary Artery Using the “Mother-and-Child” Technique

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Manabu Ogita ◽  
Satoru Suwa ◽  
Taketo Sonoda ◽  
Shuta Tsuboi ◽  
Katsumi Miyauchi ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Right Coronary Artery ◽  
Coronary Intervention ◽  
Rotational Atherectomy ◽  
Stent Expansion ◽  
Calcified Lesion ◽  
Percutaneous Coronary ◽  
Mother And Child ◽  
The Right ◽  
Anomalous Coronary

Percutaneous coronary intervention (PCI) involving the anomalous coronary artery is challenging with respect to difficulty in achieving stable catheterization. Rotational atherectomy (RA) can facilitate severely calcified lesions to improve stent delivery and stent expansion; however, its utility in tortuous and angulated coronary arteries is limited with difficulty in delivery of the RA burr. The mother-and-child technique is effective for complex PCIs with increased backup force for device delivery in such complicated cases. We report a case of successful rotational atherectomy using the “mother-and-child” technique with a Dio thrombus aspiration catheter for an angulated calcified lesion in an anomalous origin of the right coronary artery.

Tunnelling a calcified total occlusion

2021 ◽  
pp. 021849232110410
Author(s):  
Jogendra Singh ◽  
Dibyasundar Mahanta ◽  
Rudra P Mahapatra ◽  
Ramachandra Barik
Keyword(s):  
Coronary Artery ◽  
High Risk ◽  
Right Coronary Artery ◽  
Chronic Total Occlusion ◽  
Coronary Intervention ◽  
Alternative Technique ◽  
Total Occlusion ◽  
Alternative Approach ◽  
Calcific Plaque ◽  
The Right

Among the complex and high-risk coronary intervention cases, a calcified total occlusion of coronary artery poses a great challenge. We came across a 48 years old male who had calcified total occlusion of the right coronary artery. The chronic total occlusion was crossed using Nic-Nano balloon and the calcific plaque was modified using intravascular lithotripsy as an alternative technique to rotational atherectomy which we felt as an evolving alternative approach to treat the calcified total occlusion.

scholarly journals Rotational Atherectomy-Assisted Crossing of a Complex Right Coronary Artery Lesion Using the Retrograde Approach

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Abdul-Subulr Yakubu ◽  
Xiaoqiang Zhang ◽  
Bin Zhang
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Right Coronary Artery ◽  
Chronic Total Occlusion ◽  
Coronary Intervention ◽  
Rotational Atherectomy ◽  
Retrograde Approach ◽  
Total Occlusion ◽  
Interventional Cardiologist ◽  
Percutaneous Coronary

Chronic total occlusion lesions present a major challenge for the interventional cardiologist. In this case, we report the successful use of rotational atherectomy to facilitate retrograde percutaneous coronary intervention of a complex totally occluded right coronary artery after modification of the proximal cap of the lesion to enable placement of the RotaWire in the vessel architecture.

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