1/55. Late stent malapposition occurring after intracoronary beta-irradiation detected by intravascular ultrasound.We report a case of late stent malapposition occurring 6 months after intracoronary beta-irradiation detected by three-dimensional intravascular ultrasound, in spite of good apposition immediately after the procedure. Volumetric quantification revealed that stent volume remained unchanged, whereas total vessel volume increased by 13% after 6 months within the stent area. The increase of the vessel volume took place mainly in the proximal part of the stent, where the malapposition was located.- - - - - - - - - - ranking = 1keywords = area (Clic here for more details about this article) |
2/55. Stenting to reverse left ventricular ischemia due to left main coronary artery compression in primary pulmonary hypertension.Angina is a common symptom of severe pulmonary hypertension. Although many theories for the source of this pain have been proposed, right ventricular ischemia is the one most commonly accepted as the cause. We report on two patients with primary pulmonary hypertension who had angina with normal activity or on provocation. One patient had severe left ventricular dysfunction. Both were found to have severe ostial stenosis of the left main coronary artery as a result of compression from a dilated pulmonary artery. Both patients underwent stenting of the left main coronary artery with excellent angiographic results, and complete resolution of the signs and symptoms of angina and left ventricular ischemia. Left ventricular ischemia due to compression of the left main coronary artery may be a much more common mechanism of angina and left ventricular dysfunction in patients with pulmonary hypertension than previously acknowledged. Stenting of the coronary artery can be done safely with the resolution of these symptoms.- - - - - - - - - - ranking = 7.1111111111111keywords = pain (Clic here for more details about this article) |
3/55. Ostial stenosis of coronary arteries after complete replacement of aortic root using gelatin-resorcinol-formaldehyde glue.Coronary ostial stenosis between an interposition graft and coronary artery is rare and fatal. A 46-year-old woman who had reconstruction of both coronary arteries using interposition grafts for type A acute dissecting aneurysm presented with acute chest pain. Emergent coronary artery bypass grafting was done with saphenous vein grafts. Inappropriate use of gelatin-resorcinol-formaldehyde glue can be associated with ostial stenosis in the long term. Transesophageal echocardiography is useful to diagnose ostial stenosis of the coronary arteries.- - - - - - - - - - ranking = 3375.5015389351keywords = chest pain, chest, pain (Clic here for more details about this article) |
4/55. Spontaneous coronary artery spasm during coronary angiography in a patient with exercise-induced ST segment elevation.We describe a patient with a history of early morning chest pain who developed ST segment elevation during a treadmill exercise test. Severe coronary artery stenosis was identified initially and was relieved after intracoronary administration of nitroglycerin. A history of vasospastic angina in this patient facilitated prompt diagnosis.- - - - - - - - - - ranking = 3375.5015389351keywords = chest pain, chest, pain (Clic here for more details about this article) |
5/55. Y stenting of a bifurcation stenosis using a new radiopaque stent.A case of Y stenting using radiopaque stents for a bifurcation stenosis is described. Angiography and intravascular ultrasound demonstrate that in spite of optimal stent placement there is an area of the lesion that is not fully covered by the stents. This may predispose to subacute thrombosis and restenosis. This case illustrates a potential deficiency of this type of bifurcation stenting.- - - - - - - - - - ranking = 1keywords = area (Clic here for more details about this article) |
6/55. Fractional flow reserve in a patient with intermediate coronary stenosis and hypertrophic cardiomyopathy.We discuss the case of a 61-year-old male patient with hypertrophic cardiomyopathy and chest pain on exertion. coronary angiography and intravascular ultrasound revealed an intermediate stenosis in the proximal site of the left anterior descending artery, while Tc-99m myocardial scintigraphy revealed exercise-induced myocardial ischemia in the anteroseptal wall and apical portion. Flow velocity-derived coronary flow reserve (CFR) and pressure-derived fractional flow reserve (FFRmyo) were both low (1.1 and 0.59), suggesting that the stenosis was functionally significant. Directional coronary atherectomy greatly improved the FFRmyo (0.99), the scintigraphic findings, and anginal pain but did not improve the CFR (1.2). FFRmyo was useful in assessing the functional significance of an equivocal coronary stenosis and its interventional resolution.- - - - - - - - - - ranking = 3382.6126500462keywords = chest pain, chest, pain (Clic here for more details about this article) |
7/55. Traumatic total occlusion of left main coronary artery caused by blunt chest trauma.myocardial infarction is a rare complication that can occur immediately after a blunt chest trauma. We report a 36-year-old male who experienced a fatal anterolateral myocardial infarction after a nonpenetrating chest injury sustained in a car accident. Injuries of the coronary arteries associated with blunt chest trauma predominantly affect the left anterior descending artery. This is the first case of traumatic complete occlusion of the left main coronary artery (LMCA) demonstrated by coronary angiography.- - - - - - - - - - ranking = 674.44806094183keywords = chest (Clic here for more details about this article) |
8/55. Multiple complex coronary plaques in a patient with acute myocardial infarction.This report describes the case of a patient who developed acute myocardial infarction with ST segment elevation in anterior and inferior leads, simultaneously. After treatment with systemic thrombolysis, and after an initial short-lasting symptomatic improvement, chest pain and ST segment elevation recurred. coronary angiography revealed severe complex stenotic lesions at both the right coronary artery and the left anterior descending (LAD) coronary artery. Percutaneous coronary angioplasty and stent implantation were successfully performed at both lesions. This case supports the concept that, at least in some patients, acute coronary artery disease reflects a diffuse pathophysiologic process that may lead to multifocal plaque instability associated with clinical instability at multiple sites.- - - - - - - - - - ranking = 3375.5015389351keywords = chest pain, chest, pain (Clic here for more details about this article) |
9/55. Cutting balloon angioplasty through stent struts of a jailed sidebranch ostial lesion.The treatment of sidebranch ostial lesions jailed after stent implantation is challenging. We report a case of successful Cutting Balloon angioplasty through stent struts of a severe, elastic sidebranch ostial lesion. Three-day follow-up angiography showed no recurrent stenosis. The patient was discharged with complete resolution of chest discomfort and the post-hospitalization course was uneventful. Cutting Balloon angioplasty may be an optimal strategy for the treatment of elastic ostial lesions in smaller vessels that are suboptimal for stenting. The long-term benefits of using a Cutting Balloon for the treatment of sidebranch ostial lesions are still to be determined.- - - - - - - - - - ranking = 96.34972299169keywords = chest (Clic here for more details about this article) |
10/55. Limb ischemia due to use of internal thoracic artery in coronary bypass.Immediately after undergoing coronary bypass grafting using the left internal thoracic artery, a 59-year-old man developed left leg ischemia. Right-to-left femoral artery crossover bypass was performed and the ischemia resolved. A 72-year-old man developed left calf pain 12 days after a similar procedure; peripheral angiography revealed stenosis of the abdominal aorta and distal peripheral arteries, which did not require intervention.- - - - - - - - - - ranking = 7.1111111111111keywords = pain (Clic here for more details about this article) |
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