Trung Quang Le , Jacob Hayden , Lorenzo Azzalini , Taishi Hirai
{"title":"Improvement of ischemia by subintimal tracking and re-entry in chronic total occlusion percutaneous coronary intervention","authors":"Trung Quang Le , Jacob Hayden , Lorenzo Azzalini , Taishi Hirai","doi":"10.1016/j.crmic.2024.100043","DOIUrl":"10.1016/j.crmic.2024.100043","url":null,"abstract":"<div><p>A 56-year-old male truck driver with history of percutaneous coronary intervention (PCI) to the left circumflex artery presented for worsening angina. A nuclear stress test showed a moderate reversible defect of the inferior wall. A chronic total occlusion of the mid right coronary artery with patent circumflex stent was documented by coronary angiography. After unsuccessful attempts with anterograde and retrograde wiring and dissection re-entry techniques, the subintimal tracking and re-entry (STAR) technique was utilized to advance the guidewire in an extraplaque fashion into the posterior descending artery and posterolateral branch with kissing balloon angioplasty at the bifurcation. A repeat stress test, as required by the state Department of Transportation, demonstrated a resolution of the previous reversible ischemia defect. The patient's symptoms also improved after STAR. Our case highlights an objective improvement of ischemia after STAR.</p></div>","PeriodicalId":100217,"journal":{"name":"Cardiovascular Revascularization Medicine: Interesting Cases","volume":"3 ","pages":"Article 100043"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S295027562400039X/pdfft?md5=7b187f83085f1f6d76d32fb3bbe42a04&pid=1-s2.0-S295027562400039X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142097318","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}
Ahmed Al-Ogaili , Salman Allana , Yader Sandoval , Emmanouil S. Brilakis
{"title":"Intracoronary snaring to overcome severe tortuosity in chronic total occlusion percutaneous coronary intervention","authors":"Ahmed Al-Ogaili , Salman Allana , Yader Sandoval , Emmanouil S. Brilakis","doi":"10.1016/j.crmic.2024.100041","DOIUrl":"10.1016/j.crmic.2024.100041","url":null,"abstract":"<div><p>Severe tortuosity poses a challenge for chronic total occlusion (CTO) operators and decreases the success rate of CTO percutaneous coronary intervention (PCI). Extreme angulations are more common in patients with prior coronary artery bypass surgery (CABG) especially at the distal graft anastomosis. We present three challenging CTO PCI cases performed in patients with prior CABG during which intracoronary snaring was implemented to overcome severe tortuosity and successfully recanalize the occlusions.</p></div>","PeriodicalId":100217,"journal":{"name":"Cardiovascular Revascularization Medicine: Interesting Cases","volume":"3 ","pages":"Article 100041"},"PeriodicalIF":0.0,"publicationDate":"2024-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950275624000376/pdfft?md5=f179ef565498418d0bbb5d3d161eaffb&pid=1-s2.0-S2950275624000376-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141844206","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}
Mahmut Ekrem Cunetoglu, Volkan Kozluca, Bilge Nazar Ates, Cagdas Ozdol, Ali Timucin Altin
{"title":"An unusual retrieval of semi-detached stent: A multistage procedure","authors":"Mahmut Ekrem Cunetoglu, Volkan Kozluca, Bilge Nazar Ates, Cagdas Ozdol, Ali Timucin Altin","doi":"10.1016/j.crmic.2024.100042","DOIUrl":"10.1016/j.crmic.2024.100042","url":null,"abstract":"<div><p>The occurrence of coronary artery stent detachment from the balloon is infrequent during cardiac procedures, although it poses a potentially grave consequence. It can result in the development of induced coronary thrombosis, myocardial infarction, and disruption of peripheral and cerebral blood circulation. There is no universally accepted procedure for extracting the stent, however, several techniques and their combinations can be employed based on the specific circumstances of the case and the ingenuity of the operator. Various techniques were employed to extract the stripped stent in the right coronary artery (RCA), and ultimately it was effectively retrieved using an untested approach.</p></div>","PeriodicalId":100217,"journal":{"name":"Cardiovascular Revascularization Medicine: Interesting Cases","volume":"3 ","pages":"Article 100042"},"PeriodicalIF":0.0,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950275624000388/pdfft?md5=10fa7b9c42f39a3e2c4337efaa7d6877&pid=1-s2.0-S2950275624000388-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141846953","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}
Ahmad Jabri, Obadah Aqtash, Pedro Engel, Tiberio Frisoli, Mir Babar Basir
{"title":"Challenging coronary access in a patient with delayed coronary obstruction following TAVR, facilitated by the use of a dual lumen microcatheter","authors":"Ahmad Jabri, Obadah Aqtash, Pedro Engel, Tiberio Frisoli, Mir Babar Basir","doi":"10.1016/j.crmic.2024.100039","DOIUrl":"https://doi.org/10.1016/j.crmic.2024.100039","url":null,"abstract":"<div><p>Late onset coronary occlusion post-transcatheter aortic valve replacement (TAVR) is a rare yet significant complication. We present an 85-year-old female with chest pain secondary to left main coronary artery obstruction eleven months post-TAVR. Angiography revealed a partial occlusion necessitating percutaneous coronary intervention. Despite initial challenges in engagement due to interaction with the TAVR valve, use of a dual lumen microcatheter facilitated successful stenting, resulting in resolution of the obstruction. This case underscores the diagnostic and therapeutic complexities of late coronary occlusion after TAVR, emphasizing the importance of vigilant recognition and innovative interventional strategies in optimizing patient outcomes.</p></div>","PeriodicalId":100217,"journal":{"name":"Cardiovascular Revascularization Medicine: Interesting Cases","volume":"3 ","pages":"Article 100039"},"PeriodicalIF":0.0,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950275624000352/pdfft?md5=4a8c305d4802f23c4459c7ddfa474f0e&pid=1-s2.0-S2950275624000352-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141582838","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}
Sara Hazaveh , Zhongying Liu-An , Marian Vandyck-Acquah , Daniel Huq , Haroon Faraz
{"title":"Coronary vasospasm masquerading as multivessel coronary artery disease in a patient with undiagnosed thyrotoxicosis","authors":"Sara Hazaveh , Zhongying Liu-An , Marian Vandyck-Acquah , Daniel Huq , Haroon Faraz","doi":"10.1016/j.crmic.2024.100038","DOIUrl":"https://doi.org/10.1016/j.crmic.2024.100038","url":null,"abstract":"<div><p>Spontaneous coronary vasospasm (SCV) can present as coronary stenosis on angiography. Undiagnosed thyrotoxicosis is a rare cause of SCV and patients with unclear history and workup presenting with unstable angina should have thyroid function tested.</p></div>","PeriodicalId":100217,"journal":{"name":"Cardiovascular Revascularization Medicine: Interesting Cases","volume":"3 ","pages":"Article 100038"},"PeriodicalIF":0.0,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950275624000340/pdfft?md5=9c57419b2728bbfc56ad67d1c39f4c21&pid=1-s2.0-S2950275624000340-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141542408","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}
Francesco Moretti , Attilio Restivo , Irene Pescetelli , Angelina Vassileva , Luigi Fiocca , Paolo Canova
{"title":"Guiding the way: A seamless strategy for internal mammary artery cannulation","authors":"Francesco Moretti , Attilio Restivo , Irene Pescetelli , Angelina Vassileva , Luigi Fiocca , Paolo Canova","doi":"10.1016/j.crmic.2024.100035","DOIUrl":"https://doi.org/10.1016/j.crmic.2024.100035","url":null,"abstract":"<div><p>Percutaneous coronary interventions (PCI) in patients with prior coronary artery bypass grafting (CABG) could present significant challenges, especially when the navigation of arterial conduits is necessary. The selective cannulation of internal mammary artery (IMA) is the first step of these high-risk procedures, in which technical complexities and ischemic complications are frequently faced. Acknowledging the lack of pre-shaped guiding catheter alternatives, IMA cannulation is time and contrast–consuming and potentially dangerous, as both catheter probing and wiring attempts may threaten vessel integrity.</p><p>To address this unmet need we developed a novel, easy-to-use technique to achieve selective internal mammary artery (IMA) graft cannulation. Our method proposes to first engage the arterial graft by means of any diagnostic catheter, whose shape can be chosen according to the specific features of the graft. Afterwards, a 0.014-inch workhorse guidewire is advanced to the distal segment of the graft. A 5- or 6-French IM guiding catheter is finally tracked over the wire rail into the ostium to reach stable engagement, ensuring procedural success. This approach is applicable irrespective of access route (ipsilateral or contralateral, transradial or transfemoral), and ultimately reduces procedural complexities and ischemic risks associated with traditional practice. This method also promotes the adoption of smaller guide catheters, thus reducing the ischemic triggers during selective cannulation. Furthermore, it offers versatility in catheter selection and guidewire support, enhancing personalization to diverse patient anatomies and clinical scenarios.</p><p>By streamlining procedures and improving success rates, our technique represents a significant advancement in PCI via IMA grafts, promising safer and more efficient interventions for CABG patients.</p></div>","PeriodicalId":100217,"journal":{"name":"Cardiovascular Revascularization Medicine: Interesting Cases","volume":"3 ","pages":"Article 100035"},"PeriodicalIF":0.0,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950275624000315/pdfft?md5=22fba253b2ed2fbc9b4565c6e285211d&pid=1-s2.0-S2950275624000315-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141595478","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}
Hannah Lee , Sudhi Tyagi , Paul Pearson , Peter Mason
{"title":"Sentinel cerebral embolic protection device deployment in aberrant right subclavian artery via left radial artery access","authors":"Hannah Lee , Sudhi Tyagi , Paul Pearson , Peter Mason","doi":"10.1016/j.crmic.2024.100037","DOIUrl":"https://doi.org/10.1016/j.crmic.2024.100037","url":null,"abstract":"<div><p>Procedure-related stroke represents a major complication of transcatheter aortic valve replacement (TAVR). The Sentinel Cerebral Protection System is the only FDA-approved embolic protection device for TAVR and is intended for use via right radial access. As TAVR has become the preferred modality for aortic valve replacement, protection devices like Sentinel have been developed to reduce procedural complications; however, its use in aberrant aortic arch anatomy has not been previously reported. We present a case of successful Sentinel deployment and embolic protection via alternative left radial artery access in a patient with an aberrant right subclavian artery.</p></div>","PeriodicalId":100217,"journal":{"name":"Cardiovascular Revascularization Medicine: Interesting Cases","volume":"3 ","pages":"Article 100037"},"PeriodicalIF":0.0,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950275624000339/pdfft?md5=25f8b9af4ba72b3a2df62d738a796e71&pid=1-s2.0-S2950275624000339-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141542407","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}
Saliha Erdem , Joe Aoun , Gerald Lawrie , Masroor Khan , Donnell K. Bowen , Nadeen Faza , Stephen H. Little , Sachin S. Goel
{"title":"Mitral transcatheter edge-to-edge repair as a treatment option for hemolytic anemia after surgical mitral valve repair: A report of three cases","authors":"Saliha Erdem , Joe Aoun , Gerald Lawrie , Masroor Khan , Donnell K. Bowen , Nadeen Faza , Stephen H. Little , Sachin S. Goel","doi":"10.1016/j.crmic.2024.100034","DOIUrl":"https://doi.org/10.1016/j.crmic.2024.100034","url":null,"abstract":"<div><p>Hemolytic anemia following surgical mitral valve repair is rare, and the role of mitral transcatheter edge-to-edge repair (TEER) in its treatment is unknown. We present three cases of hemolytic anemia following surgical mitral valve repair treated with mitral TEER. All three patients experienced resolution of hemolysis after mitral TEER.</p></div>","PeriodicalId":100217,"journal":{"name":"Cardiovascular Revascularization Medicine: Interesting Cases","volume":"3 ","pages":"Article 100034"},"PeriodicalIF":0.0,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950275624000303/pdfft?md5=b4a5b2856d5de8f6d6bc92632750e334&pid=1-s2.0-S2950275624000303-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141481256","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}
Waseem Nosair , Merna Hussien , Monvadi B. Srichai , Carolina Valdiviezo , Gaby Weissman , Thomas E. MacGillivray , Lowell F. Satler , Ron Waksman , Brian C. Case , Nardos Temesgen
{"title":"Successful conservative management of large multivessel infected coronary artery pseudoaneurysms from complicated staphylococcal bacteremia","authors":"Waseem Nosair , Merna Hussien , Monvadi B. Srichai , Carolina Valdiviezo , Gaby Weissman , Thomas E. MacGillivray , Lowell F. Satler , Ron Waksman , Brian C. Case , Nardos Temesgen","doi":"10.1016/j.crmic.2024.100033","DOIUrl":"https://doi.org/10.1016/j.crmic.2024.100033","url":null,"abstract":"<div><p>A 59-year-old male with incompletely treated aortic valve endocarditis from complicated methicillin-sensitive Staphylococcus aureus bacteremia presented with acute left lower-extremity osteomyelitis. He was found to have new large infected coronary artery aneurysms, which were confirmed by multimodality imaging. This case highlights key decision-making by the multidisciplinary team.</p></div>","PeriodicalId":100217,"journal":{"name":"Cardiovascular Revascularization Medicine: Interesting Cases","volume":"3 ","pages":"Article 100033"},"PeriodicalIF":0.0,"publicationDate":"2024-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950275624000297/pdfft?md5=1441521589f3ef981a569ca7b2d7cd16&pid=1-s2.0-S2950275624000297-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141433784","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}
Selcuk Ozturk, Ibrahim Halil Inanc, Huseyin Kandemir
{"title":"Complete dislodgement of a deployed coronary stent in a severely calcified lesion","authors":"Selcuk Ozturk, Ibrahim Halil Inanc, Huseyin Kandemir","doi":"10.1016/j.crmic.2024.100030","DOIUrl":"https://doi.org/10.1016/j.crmic.2024.100030","url":null,"abstract":"<div><p>Coronary stent dislodgement (CSD) during percutaneous coronary intervention is a rare complication nowadays, thanks to equipment design and stent technology improvements. Coronary calcification, inadequate lesion preparation and suboptimal stent expansion are some of the risk factors for the occurrence of CSD. On the other hand, complete dislodgement of a deployed coronary stent is extraordinarily rare and infrequently reported in the literature. Herein, we describe a complete CSD case after deployment in a severely calcified right coronary artery lesion and discuss strategies to prevent this severe complication.</p></div>","PeriodicalId":100217,"journal":{"name":"Cardiovascular Revascularization Medicine: Interesting Cases","volume":"2 ","pages":"Article 100030"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950275624000261/pdfft?md5=a58a951526befc22a623489bddad60f9&pid=1-s2.0-S2950275624000261-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141243412","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}