Pub Date : 2024-12-01DOI: 10.1016/j.crmic.2024.100050
Ryan Wallace , Ryan Kabir , Benjamin B. Kenigsberg , Monvadi B. Srichai , Christian C. Shults , Michael Slack , Toby Rogers
A 39-year-old man with a history of bicuspid aortic valve and limited medical follow up presented with cardiogenic shock. He was discovered to have aortic coarctation, for which he underwent percutaneous endovascular intervention to optimize hemodynamics and lower surgical risk prior to aortic valve and aortic arch replacement. This case highlights the role of a heart team approach when managing critically ill patients with bicuspid aortic valve disease and associated aortopathies.
{"title":"Percutaneous repair of aortic coarctation: Bridging the gap to surgical repair","authors":"Ryan Wallace , Ryan Kabir , Benjamin B. Kenigsberg , Monvadi B. Srichai , Christian C. Shults , Michael Slack , Toby Rogers","doi":"10.1016/j.crmic.2024.100050","DOIUrl":"10.1016/j.crmic.2024.100050","url":null,"abstract":"<div><div>A 39-year-old man with a history of bicuspid aortic valve and limited medical follow up presented with cardiogenic shock. He was discovered to have aortic coarctation, for which he underwent percutaneous endovascular intervention to optimize hemodynamics and lower surgical risk prior to aortic valve and aortic arch replacement. This case highlights the role of a heart team approach when managing critically ill patients with bicuspid aortic valve disease and associated aortopathies.</div></div>","PeriodicalId":100217,"journal":{"name":"Cardiovascular Revascularization Medicine: Interesting Cases","volume":"4 ","pages":"Article 100050"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142743688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-14DOI: 10.1016/j.crmic.2024.100051
Sreenivas Reddy S , Raghavendra Rao K , Ankit Gupta , Jaspreet Kaur , Vikas Kadiyala , Munish Dev , Manpreet Kaur
Background
Left main coronary artery (LMCA) chronic total occlusion (CTO) is a rare presentation of atherosclerotic coronary artery disease (CAD). Clinical spectrum of presentations range from angina, heart failure, sudden cardiac arrest to very rarely asymptomatic. Percutaneous coronary intervention (PCI) of a LMCA CTO is technically challenging and complex.
Case summary
We report a 60 year old diabetic male who presented with angina on exertion of 2 years with a positive treadmill exercise stress testing. Coronary angiography showed left main coronary artery ostial CTO with retrograde filling of left anterior descending artery (LAD) and left circumflex artery (LCX) via collaterals from right coronary artery (RCA) which was dominant. The J-CTO Score was 2, SYNTAX score was 31 and the EuroSCORE II was 0.55 %. The CTO was successfully revascularized using antegrade wire escalation technique and a left main provisional stenting was performed under intravascular ultrasound (IVUS) guidance.
Discussion
Coronary artery bypass surgery is the preferred treatment option for left main chronic total occlusion. The technical advances in wire helps antegrade wire escalation and de-escalation (AWE) strategy. IVUS helped us in identification of strategies to deal with calcification and plaque modification using cutting balloon to further optimization of the stents. The guide catheter extension system (GCES) was utilized to deliver the stents in long, diffuse and calcified coronary segments. Coronary angiography at 1 year showed patent stents.
Conclusion
Left main coronary artery (LMCA) chronic total occlusion (CTO) is challenging. AWE strategy is an option for safe revascularisation and IVUS assists in plaque modification along with stent optimisation to achieve good long term outcomes.
{"title":"Percutaneous coronary intervention of ostial left main coronary artery chronic total occlusion","authors":"Sreenivas Reddy S , Raghavendra Rao K , Ankit Gupta , Jaspreet Kaur , Vikas Kadiyala , Munish Dev , Manpreet Kaur","doi":"10.1016/j.crmic.2024.100051","DOIUrl":"10.1016/j.crmic.2024.100051","url":null,"abstract":"<div><h3>Background</h3><div>Left main coronary artery (LMCA) chronic total occlusion (CTO) is a rare presentation of atherosclerotic coronary artery disease (CAD). Clinical spectrum of presentations range from angina, heart failure, sudden cardiac arrest to very rarely asymptomatic. Percutaneous coronary intervention (PCI) of a LMCA CTO is technically challenging and complex.</div></div><div><h3>Case summary</h3><div>We report a 60 year old diabetic male who presented with angina on exertion of 2 years with a positive treadmill exercise stress testing. Coronary angiography showed left main coronary artery ostial CTO with retrograde filling of left anterior descending artery (LAD) and left circumflex artery (LCX) via collaterals from right coronary artery (RCA) which was dominant. The J-CTO Score was 2, SYNTAX score was 31 and the EuroSCORE II was 0.55 %. The CTO was successfully revascularized using antegrade wire escalation technique and a left main provisional stenting was performed under intravascular ultrasound (IVUS) guidance.</div></div><div><h3>Discussion</h3><div>Coronary artery bypass surgery is the preferred treatment option for left main chronic total occlusion. The technical advances in wire helps antegrade wire escalation and de-escalation (AWE) strategy. IVUS helped us in identification of strategies to deal with calcification and plaque modification using cutting balloon to further optimization of the stents. The guide catheter extension system (GCES) was utilized to deliver the stents in long, diffuse and calcified coronary segments. Coronary angiography at 1 year showed patent stents.</div></div><div><h3>Conclusion</h3><div>Left main coronary artery (LMCA) chronic total occlusion (CTO) is challenging. AWE strategy is an option for safe revascularisation and IVUS assists in plaque modification along with stent optimisation to achieve good long term outcomes.</div></div>","PeriodicalId":100217,"journal":{"name":"Cardiovascular Revascularization Medicine: Interesting Cases","volume":"4 ","pages":"Article 100051"},"PeriodicalIF":0.0,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142699422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-14DOI: 10.1016/j.crmic.2024.100049
Javad Jalili, Sarah Vaseghi, Mahdiyeh Baastani Khajeh
Patients with end-stage renal disease (ESRD) who are on long-term hemodialysis are at heightened risk for vascular complications such as thrombosis, stenosis, and central venous obstruction. This case report presents the challenges in managing a 54-year-old female ESRD patient with multiple comorbidities who developed central venous occlusions, requiring endovascular interventions. Venoplasty of the superior vena cava (SVC) led to the rare but devastating complication of SVC rupture, cardiac tamponade, and hemothorax. Prompt recognition and immediate interventions, including balloon tamponade, pericardial drainage, and pleural catheter placement, were crucial in stabilizing the patient. This report highlights the intricate challenges in managing vascular complications and iatrogenic injuries in ESRD patients undergoing hemodialysis, emphasizing the need for the development of clinical guidelines to enhance care for this vulnerable population.
{"title":"Challenges in managing vascular complications and iatrogenic injuries in end-stage renal disease: A case report","authors":"Javad Jalili, Sarah Vaseghi, Mahdiyeh Baastani Khajeh","doi":"10.1016/j.crmic.2024.100049","DOIUrl":"10.1016/j.crmic.2024.100049","url":null,"abstract":"<div><div>Patients with end-stage renal disease (ESRD) who are on long-term hemodialysis are at heightened risk for vascular complications such as thrombosis, stenosis, and central venous obstruction. This case report presents the challenges in managing a 54-year-old female ESRD patient with multiple comorbidities who developed central venous occlusions, requiring endovascular interventions. Venoplasty of the superior vena cava (SVC) led to the rare but devastating complication of SVC rupture, cardiac tamponade, and hemothorax. Prompt recognition and immediate interventions, including balloon tamponade, pericardial drainage, and pleural catheter placement, were crucial in stabilizing the patient. This report highlights the intricate challenges in managing vascular complications and iatrogenic injuries in ESRD patients undergoing hemodialysis, emphasizing the need for the development of clinical guidelines to enhance care for this vulnerable population.</div></div>","PeriodicalId":100217,"journal":{"name":"Cardiovascular Revascularization Medicine: Interesting Cases","volume":"4 ","pages":"Article 100049"},"PeriodicalIF":0.0,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142699421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-08DOI: 10.1016/j.crmic.2024.100048
Stefano Sasso , Marcello Marchetta , Andrea Moretti , Vincenzo Bernardo , Gaetano Chiricolo , Giuseppe Massimo Sangiorgi
Percutaneous coronary intervention (PCI) is a common procedure for treating coronary artery disease, but it can be complicated by the loss and fracture of coronary guidewires within the vascular system, leading to severe complications such as vessel damage, occlusion, and embolization. This case report describes a unique and challenging scenario involving an 81-year-old male patient who, during an elective coronary angiography, was found to have a fractured and partially decoiled coronary guidewire extending from the aortic root to the left subclavian artery. The guidewire had likely been left in place during a previous procedure and was not documented in the patient's medical history. Given the potential for life-threatening complications, including occlusion of the left internal mammary artery graft, a percutaneous retrieval was attempted. Initial efforts using a snare system were unsuccessful. However, the guidewire was successfully retrieved using the “twirling guidewires” technique, which involved entangling the fractured wire with three 0.014-inch guidewires and carefully extracting it through a guide catheter. The patient avoided invasive surgery and was discharged without complications the day after. This case highlights the importance of recognizing and managing lost guidewire fragments using various percutaneous techniques, underscoring the need for interventional cardiologists to be adept in both coronary and peripheral retrieval strategies.
{"title":"Abandoned guidewire recapture from aortic root using “Guidewire twirling technique”","authors":"Stefano Sasso , Marcello Marchetta , Andrea Moretti , Vincenzo Bernardo , Gaetano Chiricolo , Giuseppe Massimo Sangiorgi","doi":"10.1016/j.crmic.2024.100048","DOIUrl":"10.1016/j.crmic.2024.100048","url":null,"abstract":"<div><div>Percutaneous coronary intervention (PCI) is a common procedure for treating coronary artery disease, but it can be complicated by the loss and fracture of coronary guidewires within the vascular system, leading to severe complications such as vessel damage, occlusion, and embolization. This case report describes a unique and challenging scenario involving an 81-year-old male patient who, during an elective coronary angiography, was found to have a fractured and partially decoiled coronary guidewire extending from the aortic root to the left subclavian artery. The guidewire had likely been left in place during a previous procedure and was not documented in the patient's medical history. Given the potential for life-threatening complications, including occlusion of the left internal mammary artery graft, a percutaneous retrieval was attempted. Initial efforts using a snare system were unsuccessful. However, the guidewire was successfully retrieved using the “twirling guidewires” technique, which involved entangling the fractured wire with three 0.014-inch guidewires and carefully extracting it through a guide catheter. The patient avoided invasive surgery and was discharged without complications the day after. This case highlights the importance of recognizing and managing lost guidewire fragments using various percutaneous techniques, underscoring the need for interventional cardiologists to be adept in both coronary and peripheral retrieval strategies.</div></div>","PeriodicalId":100217,"journal":{"name":"Cardiovascular Revascularization Medicine: Interesting Cases","volume":"4 ","pages":"Article 100048"},"PeriodicalIF":0.0,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142657959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
An inverted left atrial appendage (ILAA) is a rare occurrence after cardiac surgery and can be misinterpreted as a left atrial thrombus, mass, or vegetation. Transesophageal echocardiography (TEE) used post-operatively is useful in detailed visualization of the left atrium and any abnormality within it. We present a case in which a patient developed an ILAA post mitral valve replacement (MVR) and was diagnosed using TEE. We want to emphasize the importance of TEE post-operatively and that differentials for a left atrial mass must include ILAA, especially after cardiac surgery. This can help in preventing unnecessary anticoagulation and the need for surgical revision.
左房阑尾倒置（ILAA）是心脏手术后的一种罕见情况，可能会被误解为左房血栓、肿块或植被。术后使用的经食道超声心动图（TEE）有助于详细观察左心房及其内部的任何异常。我们介绍了一例患者在二尖瓣置换术（MVR）后出现 ILAA 并通过 TEE 诊断的病例。我们希望强调术后 TEE 的重要性，以及左心房肿块的鉴别必须包括 ILAA，尤其是在心脏手术后。这有助于避免不必要的抗凝治疗和手术翻修的需要。
{"title":"Inverted left atrial appendage developing after mitral valve replacement surgery","authors":"Abdul Rasheed Bahar , Paawanjot Kaur , Manmohan Singh , Shaun Cardozo","doi":"10.1016/j.crmic.2024.100046","DOIUrl":"10.1016/j.crmic.2024.100046","url":null,"abstract":"<div><div>An inverted left atrial appendage (ILAA) is a rare occurrence after cardiac surgery and can be misinterpreted as a left atrial thrombus, mass, or vegetation. Transesophageal echocardiography (TEE) used post-operatively is useful in detailed visualization of the left atrium and any abnormality within it. We present a case in which a patient developed an ILAA post mitral valve replacement (MVR) and was diagnosed using TEE. We want to emphasize the importance of TEE post-operatively and that differentials for a left atrial mass must include ILAA, especially after cardiac surgery. This can help in preventing unnecessary anticoagulation and the need for surgical revision.</div></div>","PeriodicalId":100217,"journal":{"name":"Cardiovascular Revascularization Medicine: Interesting Cases","volume":"4 ","pages":"Article 100046"},"PeriodicalIF":0.0,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142528090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01DOI: 10.1016/j.crmic.2024.100047
Akiva Rosenzveig , Shinya Unai , Venu Menon , Grant W. Reed
A 63 year old woman with a history of atrial flutter, hypertension and bicuspid aortic valve status post aortic valve replacement presented with worsening dyspnea and presyncope and echocardiography findings of bioprosthetic valve dysfunction. Imaging found a non-infectious pseudoaneurysm, with subsequent redo sternotomy finding of BioGlue causing increasing gradients.
{"title":"An enigmatic presentation of surgical bioprosthetic aortic valve stenosis","authors":"Akiva Rosenzveig , Shinya Unai , Venu Menon , Grant W. Reed","doi":"10.1016/j.crmic.2024.100047","DOIUrl":"10.1016/j.crmic.2024.100047","url":null,"abstract":"<div><div>A 63 year old woman with a history of atrial flutter, hypertension and bicuspid aortic valve status post aortic valve replacement presented with worsening dyspnea and presyncope and echocardiography findings of bioprosthetic valve dysfunction. Imaging found a non-infectious pseudoaneurysm, with subsequent redo sternotomy finding of BioGlue causing increasing gradients.</div></div>","PeriodicalId":100217,"journal":{"name":"Cardiovascular Revascularization Medicine: Interesting Cases","volume":"4 ","pages":"Article 100047"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-18DOI: 10.1016/j.crmic.2024.100044
Sandeep Kancharla, Matthew Bridges, Christopher Hinson, Alejandro Lemor
We present a case of acute coronary syndrome in a patient with coronary artery ectasia. Intravascular imaging revealed complete thrombotic occlusion of the right coronary artery. Although initial aspiration thrombectomy was ineffective, intracoronary alteplase improved subsequent aspiration attempts. Medical management with anticoagulation alongside antiplatelet therapy reduced thrombotic burden with sustained effect.
{"title":"Conquering acute coronary syndrome in coronary artery ectasia: Thrombus resolution with intracoronary thrombolysis, aspiration thrombectomy, and triple therapy","authors":"Sandeep Kancharla, Matthew Bridges, Christopher Hinson, Alejandro Lemor","doi":"10.1016/j.crmic.2024.100044","DOIUrl":"10.1016/j.crmic.2024.100044","url":null,"abstract":"<div><div>We present a case of acute coronary syndrome in a patient with coronary artery ectasia. Intravascular imaging revealed complete thrombotic occlusion of the right coronary artery. Although initial aspiration thrombectomy was ineffective, intracoronary alteplase improved subsequent aspiration attempts. Medical management with anticoagulation alongside antiplatelet therapy reduced thrombotic burden with sustained effect.</div></div>","PeriodicalId":100217,"journal":{"name":"Cardiovascular Revascularization Medicine: Interesting Cases","volume":"4 ","pages":"Article 100044"},"PeriodicalIF":0.0,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142319506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-17DOI: 10.1016/j.crmic.2024.100045
Mohammad Reza Movahed
Cardiac catheterization via the right radial artery is associated with a lower complication rate and is gaining popularity. However, there are unique challenges that can lead to procedural failure. One of the major challenges is advancing guide wire into the ascending aorta in a very tortuous subclavian artery. The deep inspiratory maneuver is one of the important maneuvers to overcome wire advancement into the aorta. However, in some cases, the wire will enter the descending aorta with great difficulty in repositioning in the ascending aorta. In this case, we describe a case of a very tortuous subclavian artery that prevents wire advancement into the ascending aorta despite repositioning the catheter and performing deep inspiratory maneuvers. However, after instructing the patient to move her head to the left, wire advancement into the ascending aorta was easily achieved. In this case report, an easy-to-perform maneuver is described in these tough situations that can save the procedure that was started via the right radial route.
{"title":"Saving right radial cardiac catheterization with tortuous subclavian artery using head left turning maneuver for facilitating wire advancement into the ascending aorta","authors":"Mohammad Reza Movahed","doi":"10.1016/j.crmic.2024.100045","DOIUrl":"10.1016/j.crmic.2024.100045","url":null,"abstract":"<div><div>Cardiac catheterization via the right radial artery is associated with a lower complication rate and is gaining popularity. However, there are unique challenges that can lead to procedural failure. One of the major challenges is advancing guide wire into the ascending aorta in a very tortuous subclavian artery. The deep inspiratory maneuver is one of the important maneuvers to overcome wire advancement into the aorta. However, in some cases, the wire will enter the descending aorta with great difficulty in repositioning in the ascending aorta. In this case, we describe a case of a very tortuous subclavian artery that prevents wire advancement into the ascending aorta despite repositioning the catheter and performing deep inspiratory maneuvers. However, after instructing the patient to move her head to the left, wire advancement into the ascending aorta was easily achieved. In this case report, an easy-to-perform maneuver is described in these tough situations that can save the procedure that was started via the right radial route.</div></div>","PeriodicalId":100217,"journal":{"name":"Cardiovascular Revascularization Medicine: Interesting Cases","volume":"4 ","pages":"Article 100045"},"PeriodicalIF":0.0,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950275624000418/pdfft?md5=5ab79eacbf7e1400356819d826cf89d7&pid=1-s2.0-S2950275624000418-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142310863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1016/j.crmic.2024.100040
Grace C. Bloomfield , Bryan J. LeBude , Ramez S.F. Jabaji , Steven R. Potter , Kalyan R. Chitturi , Lowell F. Satler , Ron Waksman , Brian C. Case
We present a case of cardiac tamponade as the presenting sign of intolerance of a failed, non-functioning transplanted kidney. Through this case, we describe a refractory systemic inflammatory response with treatment escalation and ultimate resolution through transplant nephrectomy.
{"title":"Cardiac tamponade as the first presentation of allograft intolerance of an old transplanted kidney","authors":"Grace C. Bloomfield , Bryan J. LeBude , Ramez S.F. Jabaji , Steven R. Potter , Kalyan R. Chitturi , Lowell F. Satler , Ron Waksman , Brian C. Case","doi":"10.1016/j.crmic.2024.100040","DOIUrl":"10.1016/j.crmic.2024.100040","url":null,"abstract":"<div><p>We present a case of cardiac tamponade as the presenting sign of intolerance of a failed, non-functioning transplanted kidney. Through this case, we describe a refractory systemic inflammatory response with treatment escalation and ultimate resolution through transplant nephrectomy.</p></div>","PeriodicalId":100217,"journal":{"name":"Cardiovascular Revascularization Medicine: Interesting Cases","volume":"3 ","pages":"Article 100040"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950275624000364/pdfft?md5=6a65e0002d42d280889856a853014326&pid=1-s2.0-S2950275624000364-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141853076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1016/j.crmic.2024.100036
Giuseppe Colletti , Gabriele Gasparini L. , Mihai Cocoi , Alexandre Natalis , Pierpasquale Leone , Claudiu Ungureanu
Spontaneous coronary artery dissection (SCAD) poses a significant challenge in young female patients presenting with acute coronary syndromes. We report a case of a 43-year-old female presenting with non-ST elevation acute coronary syndrome, diagnosed with SCAD. Utilizing a Suoh 0.3 guidewire and microcatheter, successful percutaneous intervention was achieved. Notably, once a position in the true lumen was established, the use of a dual-lumen microcatheter facilitated the identification of the main branch of the true lumen through side-port contrast injection and enabled safe delivery of a second wire within it. This highlights the importance of tailored interventions and innovative tools in managing SCAD effectively.
{"title":"True lumen wiring in spontaneous coronary artery dissection – Keep it true","authors":"Giuseppe Colletti , Gabriele Gasparini L. , Mihai Cocoi , Alexandre Natalis , Pierpasquale Leone , Claudiu Ungureanu","doi":"10.1016/j.crmic.2024.100036","DOIUrl":"10.1016/j.crmic.2024.100036","url":null,"abstract":"<div><p>Spontaneous coronary artery dissection (SCAD) poses a significant challenge in young female patients presenting with acute coronary syndromes. We report a case of a 43-year-old female presenting with non-ST elevation acute coronary syndrome, diagnosed with SCAD. Utilizing a Suoh 0.3 guidewire and microcatheter, successful percutaneous intervention was achieved. Notably, once a position in the true lumen was established, the use of a dual-lumen microcatheter facilitated the identification of the main branch of the true lumen through side-port contrast injection and enabled safe delivery of a second wire within it. This highlights the importance of tailored interventions and innovative tools in managing SCAD effectively.</p></div>","PeriodicalId":100217,"journal":{"name":"Cardiovascular Revascularization Medicine: Interesting Cases","volume":"3 ","pages":"Article 100036"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950275624000327/pdfft?md5=57e3f7708093f4ec40b1e083319c018d&pid=1-s2.0-S2950275624000327-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142241226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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