scholarly journals Coronary stenting using a 6 French diagnostic catheter: A case report

2013 ◽  
Vol 2 (2) ◽  
pp. 71-73
Author(s):  
Laxman Dubey ◽  
Sogunuru Guruprasad ◽  
Gangapatnam Subramanyama

Guiding catheters have larger lumen diameter as compared to the same size diagnostic catheters, and thus provide adequate arterial blood flow and good visualization of the artery during percutaneous coronary intervention. However, feasibility of percutaneous coronary intervention via diagnostic catheters has been demonstrated in a few studies. This case reports the use of a 6 French diagnostic catheter for both the coronary angiography as well as coronary stenting in a 52-year-old male patient with critical mid left anterior descending artery stenosis on December, 2012. DOI: http://dx.doi.org/10.3126/jaim.v2i2.8781 Journal of Advances in Internal Medicine 2013;02(02):71-73

2018 ◽  
Vol 03 (04) ◽  
pp. 237-239
Author(s):  
Seetharam Vankudoth ◽  
Madhurima Banoth

AbstractPercutaneous coronary intervention (PCI) for high takeoff left main is challenging, as it poses difficulties with the engagement of the guiding catheter and establishment of backup support. This report examines the case of a 53-year-old woman with history of anterior wall myocardial infarction with a ventricular septal defect (VSD), who was treated with left anterior descending (LAD) angioplasty and VSD device closure done 4 years back, and now she presented with unstable angina. After successful engagement of 5F Tiger diagnostic catheter through a right radial artery, the angiography revealed an 80% stenosis of the proximal LAD and in-stent restenosis 70% of mid-LAD. The authors tried to engage the left coronary system through the right femoral artery with 6F Judkins left, 6F Amplatzer left, 6F EBU, and 6F XBU. They could not cannulate because of high takeoff left main, so they switched to right radial access. Then they engaged a 6F 3.5 EBU catheter. Due to the weak backup support of the guiding catheter, they used another wire to stabilize it and the stent was implanted successfully. This is one of the rare case reports of PCI for high takeoff left main.


Angiology ◽  
2021 ◽  
pp. 000331972199223
Author(s):  
Jacqueline H. Morris ◽  
Junsoo Alex Lee ◽  
Scott McNitt ◽  
Ilan Goldenberg ◽  
Craig R. Narins

The activated clotting time (ACT) assay is used to monitor and titrate anticoagulation therapy with unfractionated heparin during percutaneous coronary intervention (PCI). Observations at our institution suggested a considerable difference between ACT values drawn from varying arterial sites, prompting the current study. Patients undergoing PCI with unfractionated heparin therapy were prospectively enrolled. Simultaneous arterial blood samples were drawn from the access sheath and the coronary guide catheter. Differences between Hemochron ACT values were determined, and potential interactions with clinical variables were analyzed. Immediately postprocedure, the simultaneous mean guide and sheath ACTs were 327 ± 62 seconds and 257 ± 44 seconds, respectively, with a mean difference of 70 ± 60 seconds (P < .001). Nearly all (90%) ACT values obtained via the guide catheter were higher than the concurrent ACT drawn from the sheath. Logistic regression analysis demonstrated that lower weight-adjusted heparin doses and absence of diabetes were associated with a greater difference between the ACT values. We conclude that the ACT value is substantially greater when assessed via the guide catheter versus the access sheath. Although the biological mechanisms require further study, this difference should be considered when managing anticoagulation during PCI and when reporting ACT as part of research protocols.


Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Abdul Sheikh ◽  
Khan Pohlel ◽  
Emir Veledar ◽  
Viola Vaccarino ◽  
John S Douglas ◽  
...  

Background: Thiazolidinediones (TZD) have been shown to decrease intimal hyperplasia by intravascular ultrasound after coronary stenting. However, a recent meta-analysis showed increased MI and suggested increased CV deaths with TZD use. We examined the impact of TZD use on the 1-year clinical outcomes of diabetic patients undergoing percutaneous coronary interventions. Methods: From 2000 through 2003, 598 diabetic patients underwent percutaneous coronary intervention at Emory University. Medication profiles were available for all patients who were divided into two groups: those that had a TZD as part of their diabetes regimen and those that did not. We compared the baseline clinical characteristics, angiographic characteristics, and 1 year rate of a composite endpoint of death, myocardial infarction, and revascularization between the two groups. Results: There was no difference between the two groups with regards to age, sex, baseline medical conditions, medication regimens, and overall glycemic control at the time of percutaneous coronary intervention. The lesions in both groups were of similar length, diameter, and characteristics. At 1 year the composite of death, non-fatal myocardial infarction (MI), and revascularization was not statistically different in the diabetics taking TZDs compared to those not taking TZDs (28.5% vs. 23.2%, p=0.15). There were also no differences in the rates of death and non-fatal MI. There was however a statistically significant increase in the rate of revascularization in diabetics taking TZDs compared to those not taking TZDs (25.4% vs. 17.3%, p=0.02). Conclusion: Diabetic patients undergoing coronary stenting who were on TZDs had a statistically significant increased rate of revascularization. However, there was a similar rate of the combined endpoint of death, non-fatal MI, and revascularization in all diabetic patients irrespective of TZD usages.


2010 ◽  
Vol 2010 ◽  
pp. 1-4 ◽  
Author(s):  
Marcelo A. Nakazone ◽  
Maurício N. Machado ◽  
Raphael B. Barbosa ◽  
Márcio A. Santos ◽  
Lilia N. Maia

Cardiovascular abnormalities are well-known manifestations of tertiary syphilis infections which although not frequent, are still causes of morbidity and mortality. A less common manifestation of syphilitic aortitis is coronary artery ostial narrowing related to aortic wall thickening. We report a case of a 46-year-old male admitted due to acute anterior ST elevation myocardial infarction submitted to primary percutaneous coronary intervention successfully. Coronary angiography showed a suboccluded ostial lesion of left main coronary artery. VDRL was titrated to 1/512. The patient was discharged with treatment including benzathine penicillin. Previous case reports of acute myocardial infarction in association with syphilitic coronary artery ostial stenosis have been reported, but the fact that the patient was treated by percutaneous coronary intervention is unique in this case.


2018 ◽  
Vol 33 (2) ◽  
pp. 90-93
Author(s):  
Md Tufazzal Hossen ◽  
Sayed Ali Ahsan ◽  
Md Abu Salim ◽  
Khurshed Ahmed ◽  
Md Mukhlesur Rahman ◽  
...  

Background: The effect of late percutaneous coronary intervention on left ventricular function is incompletely understood. Objectives: To evaluate the effect of late Percutaneous Coronary Intervention on LV systolic function following coronary stenting after acute anterior myocardial infarction. Methods: A total of 60 patients, > 24 hours to 6 weeks after anterior AMI who attended in UCC, BSMMU between July 2014 to June 2015 were included in this study. They underwent coronary stenting. After coronary stenting all patients were in TIMI flow-3. Serial echocardiographic assessment of LV function before and after late intervention with modified Simpson’s rule in apical 4 chamber view as well as comparison between baseline result with that of after intervention were done. The patients were on standard medical therapy in post intervention period. Result: Mean age was 54.3±8.91 years with minimum 30 years and maximum 75 years. Most of the patients were male (67%). LVESV was 60.0±14.4 ml before PCI and 58.3±15.3 ml at discharge (p value 0.091) & 44.1±17.6 ml after 3 months (p value <0.001). LVEF was 40.2±3.1% before PCI, 40.2±3.3% at discharge (p value 0.509) & 47.6±5.9% after 3 months (p value <0.001). There was no significant improvement of LV function from baseline till discharge but significant improvement occurred after 3months. Conclusion: Using echocardiographic techniques, our results showed that left ventricular volume decreased and the left ventricular ejection fraction increased significantly after three months of late intervention. Bangladesh Heart Journal 2018; 33(2) : 90-93


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