Cardiovascular Revascularization Medicine: Interesting Cases最新文献_第3页

When complications become opportunities: Guide catheter-induced dissection facilitating an unplanned investment strategy in chronic total occlusion PCI of the RCA 当并发症成为机会时：引导导管诱导的夹层有助于RCA慢性全闭塞PCI的计划外投资策略

Cardiovascular Revascularization Medicine: Interesting Cases Pub Date : 2025-06-11 DOI: 10.1016/j.crmic.2025.100085

Ghulam Mujtaba Ghumman, Sidra Kalsoom, Mohammed Taleb, Syed Sohail Ali, Zaid Al-Jebaje

{"title":"When complications become opportunities: Guide catheter-induced dissection facilitating an unplanned investment strategy in chronic total occlusion PCI of the RCA","authors":"Ghulam Mujtaba Ghumman, Sidra Kalsoom, Mohammed Taleb, Syed Sohail Ali, Zaid Al-Jebaje","doi":"10.1016/j.crmic.2025.100085","DOIUrl":"10.1016/j.crmic.2025.100085","url":null,"abstract":"<div><h3>Background</h3><div>Percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) of the right coronary artery (RCA) remains technically challenging. Guide catheter-induced dissection is typically considered a serious complication. However, in rare cases, such events may paradoxically aid in successful revascularization.</div></div><div><h3>Case Summary</h3><div>We report the case of a 43-year-old male with prior coronary artery bypass grafting (CABG) and RCA CTO, who underwent unplanned investment PCI procedure. Immediately after guide catheter engagement, contrast injection revealed a proximal RCA dissection. Instead of terminating the procedure, this unintentional dissection enabled entry into the subintimal space and facilitated guidewire passage to the distal branches. Intravascular ultrasound (IVUS) confirmed entry into the false lumen. Serial balloon angioplasty was performed, restoring TIMI-III flow to the right posterior descending artery (RPDA) and right posterolateral artery (RPLA). Remarkably, the dissection did not extend to the aortic cusp, nor did it result in perforation or pericardial effusion. The case was deemed a successful investment procedure, with staged completion in 10 weeks when patient returned for definitive revascularization. Four overlapping stents were placed from ostial RCA to RPLA with excellent results.</div></div><div><h3>Conclusion</h3><div>While coronary dissection during CTO-PCI is conventionally viewed as a complication, in select scenarios it may facilitate revascularization. Recognizing and managing such outcomes requires careful intraprocedural assessment and expertise in complex PCI.</div></div>","PeriodicalId":100217,"journal":{"name":"Cardiovascular Revascularization Medicine: Interesting Cases","volume":"8 ","pages":"Article 100085"},"PeriodicalIF":0.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144263887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

“Atrialized” minimally invasive transcatheter mitral valve-in-MAC replacement to prevent outflow tract obstruction “心房化”微创经导管二尖瓣置换术预防流出道阻塞

Cardiovascular Revascularization Medicine: Interesting Cases Pub Date : 2025-06-06 DOI: 10.1016/j.crmic.2025.100081

Luai Madanat, Richard Bloomingdale, Ahmad Jabri, Michael Gallagher, Vishal Birk, Amr E. Abbas, John Young, Rakesh M. Suri

引用次数: 0

TRI-umphant recovery: A case series of transcatheter tricuspid valve-in-valve replacement for bioprosthetic tricuspid valve stenosis 三突恢复：经导管三尖瓣瓣内置换术治疗生物假体三尖瓣狭窄一例

Cardiovascular Revascularization Medicine: Interesting Cases Pub Date : 2025-06-04 DOI: 10.1016/j.crmic.2025.100082

Nina S. Appareddy , Bradley Casey , Divyanshi Sood , Renuka Singh , Syed R. Zaidi , Manaquibb Khan , George Gibson , Bhavith Aruni , Derar Albashaireh

引用次数: 0

Extrinsic left main coronary artery compression in pulmonary hypertension with syncope debut 肺动脉高压伴晕厥的外源性冠状动脉左主干受压

Cardiovascular Revascularization Medicine: Interesting Cases Pub Date : 2025-06-01 DOI: 10.1016/j.crmic.2025.100079

Alejandro Ricalde Alcocer , Oscar Ulises Preciado-Gutiérrez , Mariana García Villarejo , Mauricio Kuri , Gerardo Payró

引用次数: 0

Zero contrast concomitant transcatheter aortic valve and coronary intervention in a patient with severe contrast allergy 严重对比剂过敏患者的无对比剂联合经导管主动脉瓣冠状动脉介入治疗

Cardiovascular Revascularization Medicine: Interesting Cases Pub Date : 2025-06-01 DOI: 10.1016/j.crmic.2025.100080

William Camilleri, Joost Daemen, Nicolas M. Van Mieghem

引用次数: 0

Erroneously deployed, old ostial RCA stent, overhanging in the aorta with symptomatic ostial severe ISR, snared, stented and successfully averted single vessel bypass 错误部署，旧的鼻腔RCA支架，悬垂在有症状的鼻腔严重ISR的主动脉，陷阱，支架和成功避免单血管旁路

Cardiovascular Revascularization Medicine: Interesting Cases Pub Date : 2025-05-28 DOI: 10.1016/j.crmic.2025.100078

Birgurman Singh , Christopher James Murray , Allan Santos Argueta , Usman Baber , Nirmal Kaur

{"title":"Erroneously deployed, old ostial RCA stent, overhanging in the aorta with symptomatic ostial severe ISR, snared, stented and successfully averted single vessel bypass","authors":"Birgurman Singh , Christopher James Murray , Allan Santos Argueta , Usman Baber , Nirmal Kaur","doi":"10.1016/j.crmic.2025.100078","DOIUrl":"10.1016/j.crmic.2025.100078","url":null,"abstract":"<div><div>We present a complex case of a 77-year-old high-surgical-risk patient with refractory angina due to severe in-stent restenosis (ISR) of a malpositioned right coronary artery (RCA) ostial stent protruding into the Aorta. Despite prior PCIs, including overlapping drug-eluting stents (DES), progressive ISR led to debilitating symptoms. Diagnostic imaging revealed an 8–10 mm aortic overhang of the RCA stent, complicating catheter engagement. A multidisciplinary team pursued percutaneous management to avoid high-risk CABG. Using femoral access and a temporary pacemaker, a malpositioned stent was successfully snared and removed. Subsequent OCT-guided PCI involved distal 3.0 × 32 mm and ostial 3.5 × 16 mm PROMUS DES deployment, optimized with intravascular imaging. The procedure restored TIMI III flow, resolving symptoms without complications. This case demonstrates the successful percutaneous retrieval and imaging-guided PCI for aortic-ostial ISR, highlighting the importance of careful planning, advanced interventional techniques, and a multidisciplinary approach to minimize the need for invasive surgery in high-risk patients.</div></div>","PeriodicalId":100217,"journal":{"name":"Cardiovascular Revascularization Medicine: Interesting Cases","volume":"8 ","pages":"Article 100078"},"PeriodicalIF":0.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144178301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pneumopericardium after pericardiocentesis 心包穿刺后心包充血

Cardiovascular Revascularization Medicine: Interesting Cases Pub Date : 2025-05-15 DOI: 10.1016/j.crmic.2025.100077

Giuseppe Andò, Alessio Villari, Giulia Cavolina, Olimpia Trio

引用次数: 0

Use of lithotripsy (IVL) in severe calcified homograft for optimizing Transcatheter Pulmonary Valve Replacement (TPVR) 经导管肺动脉瓣置换术在重度钙化同种移植物中的应用

Cardiovascular Revascularization Medicine: Interesting Cases Pub Date : 2025-05-14 DOI: 10.1016/j.crmic.2025.100076

Leo Kar Lok Lai , Hussayn Alrayes , Georgi Fram , James C. Lee , John Dawdy , Bryan Zweig , Gennaro Giustino , Ahmad Jabri , Brian P. O'Neill , Tiberio M. Frisoli , Pedro Engel Gonzalez , William W. O'Neill , Pedro A. Villablanca

引用次数: 0

Aortic arch-assisted “Tip-in” technique in coronary intervention for ostial chronic total occlusion 主动脉弓辅助“尖向”技术在口腔慢性全闭塞冠脉介入治疗中的应用

Cardiovascular Revascularization Medicine: Interesting Cases Pub Date : 2025-05-08 DOI: 10.1016/j.crmic.2025.100072

Michiya Kageyama , Satoshi Koizumi , Koichi Iwamatsu , Tomohisa Sakata , Masateru Kanai , Sawa Takayama , Masahide Aoyagi , Masashi Sakuma , Etsuo Tsuchikane , Shigeru Toyoda , Teruo Inoue

{"title":"Aortic arch-assisted “Tip-in” technique in coronary intervention for ostial chronic total occlusion","authors":"Michiya Kageyama , Satoshi Koizumi , Koichi Iwamatsu , Tomohisa Sakata , Masateru Kanai , Sawa Takayama , Masahide Aoyagi , Masashi Sakuma , Etsuo Tsuchikane , Shigeru Toyoda , Teruo Inoue","doi":"10.1016/j.crmic.2025.100072","DOIUrl":"10.1016/j.crmic.2025.100072","url":null,"abstract":"<div><div>Percutaneous coronary intervention (PCI) for ostial chronic total occlusion (CTO) remains technically demanding, and often requires the retrograde approach. We report a case of a 70-year-old man with a history of coronary artery bypass grafting who presented with exertional chest pain. Coronary angiography revealed a CTO at the ostium of the right coronary artery (RCA). Since an antegrade approach was unsuccessful, we performed a retrograde approach via septal collaterals, and then the guidewire successfully crossed the lesion into the aorta. Because we could not prepare an appropriate snare device, however, we employed an aortic arch-assisted “Tip-in” technique, in which the natural curvature and anatomical bias of the aortic arch were utilized to align and advance the retrograde guidewire into the antegrade guiding catheter under orthogonal angiographic guidance. This allowed for successful guidewire externalization and stenting for the RCA lesion. This technique provides a safe, efficient, and cost-effective in selected ostial CTO cases where standard coaxial alignment is difficult and adjunctive devices are not available.</div></div>","PeriodicalId":100217,"journal":{"name":"Cardiovascular Revascularization Medicine: Interesting Cases","volume":"7 ","pages":"Article 100072"},"PeriodicalIF":0.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143950444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A case of acquired coronary cameral fistula mimicking coronary perforation during primary PCI 原发性PCI术中获得性冠状动脉摄像瘘模拟冠状动脉穿孔1例

Cardiovascular Revascularization Medicine: Interesting Cases Pub Date : 2025-05-08 DOI: 10.1016/j.crmic.2025.100075

Souvik Sardar, Krishna Prasad Akkineni, Sumit Kumar, Aseem Basha, Atit A Gawalkar

引用次数: 0