COVID-19 Infection Complicated by a Complete Occlusion of the Left Circumflex Artery With Acute Restenosis After Drug-Eluting Stent Placement

A 75-year-old woman with past medical history of coronary bypass, atrial fibrillation, mitral valve repair undergoes percutaneous coronary intervention of left circumflex artery with a drug eluting stent. An Angio-Seal vascular closure device was used post procedure to obtain hemostasis. Shortly after deployment, frank bleeding was observed necessitating manual compression at the arteriotomy site. After hemostasis was achieved, the right lower extremity was found to be pale, bluish with feeble pulses. Doppler ultrasound was emergently performed revealing decreased blood flow after mid superficial femoral artery (SFA) and an echo lucent object lodged luminally in the SFA. Patient was urgently taken to the vascular laboratory where an Angio-Seal device, including the collagen plug and anchor, was successfully removed endovascularly patient made full recovery and was discharged home the following day.

Download Full-text

P971Impact of treatment strategy on 1-year outcome for Left Main trifurcation lesions

European Heart Journal ◽

10.1093/eurheartj/ehz747.0565 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

K Tani ◽

S Mitomo ◽

K Tanaka ◽

S Tahara ◽

S Nakamura

Keyword(s):

Clinical Outcomes ◽

Coronary Intervention ◽

Drug Eluting Stent ◽

Restenosis Rate ◽

Left Main ◽

Circumflex Artery ◽

Left Circumflex Artery ◽

Significant Difference ◽

Drug Eluting

Abstract Background/Introduction Limited data exist regarding procedural strategy and clinical outcomes after percutaneous coronary intervention (PCI) for unprotected left main (LM) trifurcation lesion. Purpose The aim of this study is to evaluate 1-year clinical outcomes after LM trifurcation PCI comparing different strategies in kissing balloon inflation (KBI). Methods From 1, January, 2011 to 31, March, 2017, patients who underwent LM trifurcation PCI with second generation drug-eluting stent in our center were retrospectively analyzed. They were categorized into single-stent KBT group (KBT in left anterior descending artery [LAD] and left circumflex artery [LCX], or LAD and high lateral branch [HL]) and no-KBT group. Primary endpoint is restenosis in the lesions. Results Among 1301 patients who underwent LM PCI during the study period, 163 patients (12.5%) had a trifurcation lesion. Regarding the number of stents used for the lesions, 1, 2 and 3 stents were used in 75.4%, 22.0% and 2.5%, respectively. Median follow-up period of LM trifurcation patients was 265 days (interquartile range: 81–564). In the no-KBT group (64 patients), 19 patients experienced restenosis of HL and LCX (HL: 8 patients, LCX: 0 patient, and both: 11 patients). In the KBT-group, KBT for LAD and LCX was performed in 47 patients, and of them, 19 patients experienced restenosis of LM-LAD, HL and LCX (HL: 12 patients, LCX: 6 patients and all: 1 patient). On the other hand, in 9 patients with KBT for LAD and HL, there were no restenosis cases at 1-year follow-up. There was no statistically significant difference in restenosis rate between the no-KBI and KBT group (29.6% vs. 40.4%, p=0.69). Restenosis rates in each segments Conclusion After LM trifurcation PCI, restenosis rate at 1-year follow-up was high, and no difference between no-KBT and KBT group overall. However, there was no restenosis case in patients with KBT for LAD and HL.

Download Full-text

A Case Summary of the Application of a Drug-Eluting Stent Combined with a Drug-Coated Balloon in Left Main Coronary Artery Disease

Cardiovascular Innovations and Applications ◽

10.15212/cvia.2021.0027 ◽

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.

Download Full-text

Subacute Drug-Eluting Stent Thrombosis Caused by Stent Underexpansion: Evaluation by Optical Coherence Tomography

Case Reports in Medicine ◽

10.1155/2011/129341 ◽

2011 ◽

Vol 2011 ◽

pp. 1-3

Author(s):

Roberto Martín-Reyes ◽

Santiago Jiménez-Valero ◽

Felipe Navarro ◽

Raúl Moreno

Keyword(s):

Optical Coherence Tomography ◽

Stent Thrombosis ◽

Drug Eluting Stent ◽

Optical Coherence ◽

Circumflex Artery ◽

St Segment Elevation ◽

Left Circumflex Artery ◽

Chronic Occlusion ◽

St Segment ◽

Drug Eluting

We present the case report of a patient presenting with ST segment elevation myocardial infarction due to a subacute drug-eluting stent trombosis within the proximal segment of the left circumflex artery (LCX). Six days before a total chronic occlusion was treated at the mid segment of the LCX by overlapping two drug-eluting stents. Optical coherence tomography (OCT) was helpful to demonstrate stent underexpansion of the overlaping segment as the main mechanism of early stent thrombosis. This case is illustrative about the potential role of OCT to identify the mechanisms of ST and thus guiding the PCI procedure. Moreover, our case shows the capability of the Imagewire to cross a severe stenosis due to stent underexpansion that could not be crossed by the IVUS catheter.

Download Full-text

Successful PCI of Anomalous Left Circumflex Coronary Artery Arising from Right Coronary Sinus – A Case Report

Cardiology and Angiology An International Journal ◽

10.9734/ca/2019/v8i230096 ◽

2019 ◽

pp. 1-4

Author(s):

Gurkirat Singh ◽

Hemant Khemani ◽

Shakil Shaikh ◽

Narender Omprakash Bansal

Keyword(s):

Coronary Artery ◽

Coronary Sinus ◽

Coronary Arteriography ◽

Anomalous Origin ◽

Drug Eluting Stent ◽

Circumflex Artery ◽

Left Circumflex Artery ◽

Coronary Syndrome ◽

Drug Eluting ◽

Significant Lesion

Coronary artery anomalies occur in 1.3-5.6% of patients undergoing coronary arteriography. An anomalous origin of LCX from right coronary sinus is the most common congenital variant. It is usually considered “benign” since it is not known to predispose individuals to sudden cardiac death. Such vessels are particularly predisposed to atherosclerotic disease in their proximal portion, due to the acute angulation of its origin from the aorta and its posterior retro aortic course. We present a case of 55 years old female admitted with acute coronary syndrome. Coronary angiogram showed the anomalous origin of the left circumflex artery from right coronary sinus. This artery had a significant lesion which was successfully stented with a drug-eluting stent.

Download Full-text

Long-Term Clinical Outcomes of Infrapopliteal Drug-Eluting Stent Placement for Critical Limb Ischemia in Diabetic Patients

Journal of Vascular and Interventional Radiology ◽

10.1016/j.jvir.2015.06.034 ◽

2015 ◽

Vol 26 (10) ◽

pp. 1423-1430 ◽

Cited By ~ 11

Author(s):

Stavros Spiliopoulos ◽

Vasiliki Theodosiadou ◽

Konstantinos Katsanos ◽

Panagiotis Kitrou ◽

George C. Kagadis ◽

...

Keyword(s):

Clinical Outcomes ◽

Critical Limb Ischemia ◽

Stent Placement ◽

Limb Ischemia ◽

Drug Eluting Stent ◽

Diabetic Patients ◽

Drug Eluting

Download Full-text

Combining clinical and angiographic variables for estimating risk of target lesion revascularization after drug eluting stent placement

Cardiovascular Revascularization Medicine ◽

10.1016/j.carrev.2016.12.014 ◽

2017 ◽

Vol 18 (3) ◽

pp. 169-176 ◽

Cited By ~ 3

Author(s):

Joshua M. Stolker ◽

David J. Cohen ◽

Kevin F. Kennedy ◽

Michael J. Pencina ◽

Suzanne V. Arnold ◽

...

Keyword(s):

Stent Placement ◽

Target Lesion ◽

Target Lesion Revascularization ◽

Drug Eluting Stent ◽

Drug Eluting

Download Full-text

A case of left circumflex artery stenosis involving ST segment depression in multiple leads with ST elevation in lead augmented vector right

International Surgery Journal ◽

10.18203/2349-2902.isj20193001 ◽

2019 ◽

Vol 6 (7) ◽

pp. 2598

Author(s):

C. P. Karunadas ◽

Cibu Mathew

Keyword(s):

Beta Blockers ◽

Coronary Intervention ◽

Drug Eluting Stent ◽

Circumflex Artery ◽

St Segment Elevation ◽

Left Circumflex Artery ◽

St Depression ◽

St Segment ◽

Lead Avr ◽

St Elevation

Electrocardiography (ECG) patterns of ST-segment elevation in lead aVR with or without diffuse ST segment depression may predict either left main coronary artery or triple vessel stenosis. Here, we have presented the case of a 56-year-old female involving such an ECG pattern with ST-segment depression in more than eight leads and ST Segment elevation in lead aVR, however, showing stenosis of the mid-segment of the left circumflex artery (LCX). She was scheduled to undergo percutaneous coronary intervention with implantation of a drug-eluting stent with respect to mid LCX stenosis. The patient was asymptomatic post procedure and was discharged on beta blockers. To conclude, the ECG pattern of ST depression in multiple leads with ST-elevation in aVR lead can occur in LCX obstruction as well.

Download Full-text