ABSTRACT
We describe a case where extreme tortuosity in the patient's iliac arterial system precluded the manipulation and therefore engagement of 8 Fr guiding catheters with our target vessel. After diagnostic coronary angiography was performed with 6 Fr catheters, successful balloon angioplasty was negotiated over a stiff guidewire without guiding catheter support. Balloon dilatation of the ostial stenosis enabled subsequent engagement with 8 Fr guiding catheter and successful stent delivery.
Subject(s)
Angioplasty, Balloon, Coronary/methods , Aged , Aged, 80 and over , Catheterization , Coronary Angiography , Humans , Male , StentsABSTRACT
We report and attempt to classify a previously undescribed coronary artery anomaly. Our patient had all three coronary arteries arising from a common ostium in the right sinus of Valsalva, with an unusual distribution to the left coronary artery system: the anomalous left circumflex system taking an intraseptal (intramyocardial) course and the anomalous left anterior descending system taking an interarterial (between the great vessels) course.
Subject(s)
Coronary Vessel Anomalies/complications , Myocardial Ischemia/etiology , Sinus of Valsalva/abnormalities , Aged , Coronary Angiography , Coronary Vessel Anomalies/classification , Coronary Vessel Anomalies/diagnosis , Follow-Up Studies , Humans , Male , Myocardial Ischemia/diagnosis , Myocardial Ischemia/therapy , Radionuclide VentriculographyABSTRACT
We describe a case in which balloon angioplasty of thrombosed saphenous vein graft stents resulted in compression and deformation of the stents because of inadvertent passage of the guidewire outside the stents. This condition was diagnosed by intravascular ultrasonography, which was then ultimately utilized to direct and optimize placement of additional stents to exclude the deformed stents from the vessel lumen.
