Volume 14 - Issue 2 - February, 2002
Report of an Undeployed Stent Causing the Unraveling of a Coronary Artery Guidewire Being Used for Sidebranch Protection
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Coronary guidewire fracture and subsequent retrieval of the retained pieces is an uncommon, but known complication of percutaneous coronary angioplasty. To our knowledge, however, this is the first report of a coronary guidewire unraveling after positioning an undeployed stent, and its successful retrieval by removal of the undeployed stent.
Case Report. A 70-year-old male who had hypertension and hypercholesterolemia was treated with primary angioplasty of his proximal right coronary artery during an acute myocardial infarction 10 weeks prior to this admission. Because of continued
Unusual Mechanism of Coronary Perforation During PTCA
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Case Description. A 79-year-old female with history of hypertension, hyperlipidemia and peripheral vascular disease underwent successful direct stenting of her left anterior descending coronary artery on March 15, 2000 in the setting of unstable angina, utilizing a 3.0 x 15 mm Medtronic/AVE S670 stent deployed at 16 atmospheres (Medtronic-AVE, Santa Clara, California). Follow-up coronary angiography on September 1, 2000 for recurrent angina revealed angiographically significant in-stent focal restenosis (Figure 1). Intravascular ultrasound (IVUS) was performed to address the possible un
Facilitated Percutaneous Intervention Following Combination Therapy with Reteplase and Abciximab for Acute Myocardial Infarcti
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Case Report. R.C. is a 45-year-old white male who presented to the Emergency Department at Largo Medical Center with a massive acute anterior wall myocardial infarction (MI). The patient denied any prior history of coronary artery disease (CAD), but admitted to intermittent chest pain over the preceding week. He had a moderately severe episode of chest pain lasting nearly 2 hours the evening before this event but the symptoms resolved spontaneously and he attributed the symptoms to indigestion. He was previously treated by his primary care physician with statin therapy for “mild” hy
“Cutting Balloon and the Three Burrs”: Treatment for Ostial Left Anterior Descending Artery In-Stent Restenosis
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In-stent restenosis (ISR) is a difficult complication to treat, occurring in 15–35% of stents deployed for de novo lesions in native coronary arteries.1,2 The restenosis rate following therapy for ISR is as high as 54%.3 Thus far, there is conflicting evidence in the literature as to the most practical approach for treating in-stent restenosis. We report a case of a left anterior descending artery (LAD) ostial in-stent restenosis treated with a combination of rotational atherectomy and “cutting” balloon percutaneous transluminal coronary angioplasty (PTCA).
Case Report. A 58
An Anomalous Left Coronary Artery Originating from the Pulmonary Artery in a 72-Year-Old Woman: Diagnosis by Color Flow Myocardi
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An anomalous origin of the left coronary artery arising from the pulmonary artery (ALCAPA) is an uncommon congenital coronary abnormality, occurring in fewer than 0.01% of patients undergoing diagnostic cardiac catheterization.1,2 Also termed Bland-White-Garland syndrome,2 ALCAPA is characterized by blood flow passing from a dilated right coronary artery to the left coronary arteries by collateral vessels and then passing retrograde to exit the anomalous left main artery into the pulmonary artery.
Usually identified during infancy or early childhood, ALCAPA is clinically manifest as ischemic
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