Journal of Medical Case Reports最新文献

{"title":"Fluconazole-induced drug rash with eosinophilia and systemic symptoms syndrome: a case report.","authors":"Stanley Kim, Kevin Chen, William Stull","doi":"10.1186/s13256-025-05321-z","DOIUrl":"https://doi.org/10.1186/s13256-025-05321-z","url":null,"abstract":"<p><strong>Background: </strong>Drug rash with eosinophilia and systemic symptoms syndrome is a severe T-cell-mediated adverse drug reaction characterized by a skin rash, fever, hematologic abnormalities, and internal organ involvement following prolonged exposure to a causative medication. Drugs associated with drug rash with eosinophilia and systemic symptoms syndrome include anticonvulsants, allopurinol, antibiotics, and nonsteroidal anti-inflammatory drugs. Fluconazole is an exceedingly rare cause of drug rash with eosinophilia and systemic symptoms syndrome, with only one previously reported case in abstract form. We present a case of a woman with pulmonary coccidioidomycosis who developed fluconazole-induced drug rash with eosinophilia and systemic symptoms syndrome, presenting with an unusual clinical feature.</p><p><strong>Case presentation: </strong>A 19-year-old Hispanic woman was taking fluconazole for pulmonary coccidioidomycosis. A total of 30 days after starting fluconazole, she developed a generalized skin rash. Despite this, she continued taking the medication. Then 1 week later, she experienced facial swelling and a sensation of \"throat closing.\" She also developed fever, axillary lymphadenopathy, eosinophilia, atypical lymphocytes, and hepatitis. Fluconazole was discontinued, and she was treated with intravenous methylprednisolone, which led to an overall improvement in her condition. During hospitalization, her antifungal therapy was switched to posaconazole. However, within 24 hours, she again experienced the \"throat closing\" sensation, which was relieved with an epinephrine injection. The patient was discharged on Day 6 with oral methylprednisolone. Again, 9 days after discharge, her symptoms recurred, including facial swelling and new skin rashes. She was readmitted and treated with famotidine, corticosteroids, and diphenhydramine. Her general condition and skin rashes gradually improved, with complete resolution of the rash 3 months after the initial eruption.</p><p><strong>Conclusion: </strong>We present a case of a woman with pulmonary coccidioidomycosis who developed drug rash with eosinophilia and systemic symptoms syndrome induced by fluconazole. Our case meets Bocquet's diagnostic criteria and is categorized as \"definite\" drug rash with eosinophilia and systemic symptoms by the Registry of Severe Cutaneous Adverse Reactions. Drug rash with eosinophilia and systemic symptoms syndrome is a T-cell-mediated type IV hypersensitivity reaction; however, our patient also exhibited a unique symptom-a sensation of \"throat closing\"-suggestive of angioedema and a Type I hypersensitivity component. This symptom appeared while she continued fluconazole after the onset of drug rash with eosinophilia and systemic symptoms syndrome and recurred upon the initiation of posaconazole. Although both fluconazole and posaconazole belong to the triazole antifungal class, true allergic cross-reactivity medicated by IgE is rare probably due to ","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"257"},"PeriodicalIF":0.9,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144181414","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}

{"title":"Fibrosarcoma of the maxilla with maxillary sinus invasion: a case report and review of the literature.","authors":"Nazanin Mahdavi, Samira Derakhshan, Mahsa Etemadi","doi":"10.1186/s13256-025-05279-y","DOIUrl":"https://doi.org/10.1186/s13256-025-05279-y","url":null,"abstract":"<p><strong>Background: </strong>Fibrosarcoma is a rare, invasive soft tissue sarcoma that is more common in males aged 30-60 years. It accounts for 1% of all malignancies in the human body. Treatment is radical surgical removal, radiotherapy, and chemotherapy.</p><p><strong>Case presentation: </strong>A 58-year-old Khorasani Persian male patient with a complaint of expansion, pain, and paresthesia in the left maxillary quadrant was diagnosed with infiltrative high-grade sarcoma. Tumoral cells were strongly diffuse positive for vimentin and negative for S100 and desmin, indicating high-grade adult fibrosarcoma.</p><p><strong>Conclusion: </strong>This report presents a rare case of a fibrosarcoma causing paresthesia, pain, and expansion in the maxilla with maxillary sinus invasion, which requires early diagnosis and immediate referral.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"254"},"PeriodicalIF":0.9,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173869","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}

{"title":"Mega solid bone cyst in iliac region from primary hyperparathyroidism: a case report.","authors":"Francesco Rosario Campo, Federico Di Sacco, Antonio D'Arienzo, Edoardo Ipponi, Fabio Cosseddu, Vanna Bottai, Sebastiano Barreca, Lorenzo Andreani, Paolo Domenico Parchi","doi":"10.1186/s13256-025-05295-y","DOIUrl":"https://doi.org/10.1186/s13256-025-05295-y","url":null,"abstract":"<p><strong>Background: </strong>Aneurysmal bone cysts are benign, locally aggressive bone lesions that commonly affect young adults and adolescents. These cysts, which may cause pain, fractures, or deformities, are often associated with vascular or abnormal bone resorption processes. Though their etiology is not fully understood, an intriguing and rarely discussed correlation between aneurysmal bone cysts and endocrine disorders, particularly primary hyperparathyroidism, has been reported. Hyperparathyroidism, usually resulting from a parathyroid adenoma, promotes osteoclastic activity, which can lead to bone resorption and potentially the formation of aneurysmal cysts. The diagnosis of hyperparathyroidism can be challenging, especially in the absence of characteristic clinical signs.</p><p><strong>Case presentation: </strong>A 47-year-old Albanian Caucasian female individual, with a body mass index of 40, presented with coxalgia and an incidental finding of an osteolytic lesion in the right sacral wing on pelvic X-ray. Subsequent imaging, including magnetic resonance imaging and computed tomography, confirmed the presence of a large aneurysmal bone cyst. Despite its size, traditional surgical interventions were not pursued owing to the discovery of primary hyperparathyroidism, as indicated by elevated serum calcium and parathyroid hormone levels. A parathyroid ultrasound revealed an atypical adenoma in the left lower parathyroid, confirming the diagnosis of hyperparathyroidism. The patient underwent successful parathyroidectomy and left thyroid loboistectomy with a favorable outcome. Postsurgical follow-up revealed normalization of metabolic parameters and clinical resolution of symptoms, with stable dimensions of the sacral cyst.</p><p><strong>Conclusion: </strong>This case emphasizes the importance of thorough diagnostic evaluation in patients with bone lesions, particularly in those with risk factors for metabolic bone disorders. Primary hyperparathyroidism, although rare, can manifest with bone abnormalities such as aneurysmal cysts. A multidisciplinary approach, including timely diagnosis and surgical intervention, is crucial for optimal management and preventing long-term complications. Regular follow-up and monitoring of metabolic parameters are key to ensuring successful outcomes.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"256"},"PeriodicalIF":0.9,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173871","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}

{"title":"Awake prone positioning in a patient with respiratory impairment due to subarachnoid hemorrhage: a case report.","authors":"Giorgia Pacchiarini, Federico Geraldini, Alessandro De Cassai, Giulia Aviani Fulvio, Annalisa Boscolo, Francesco Zarantonello, Paolo Navalesi, Marina Munari","doi":"10.1186/s13256-025-05311-1","DOIUrl":"https://doi.org/10.1186/s13256-025-05311-1","url":null,"abstract":"<p><strong>Background: </strong>Prone positioning has been shown to be an effective rescue strategy in severe acute respiratory distress syndrome and was widely used during the coronavirus disease 2019 pandemic, both in mechanically ventilated and in awake patients. Subarachnoid hemorrhage is often associated with respiratory failure. Prone positioning has been used in brain-injured patients, but concerns relating to neurological complications from intracranial hypertension still remain.</p><p><strong>Case presentation: </strong>We report the case of a 59-year-old Italian patient with subarachnoid hemorrhage who safely underwent awake prone positioning after deterioration of respiratory function.</p><p><strong>Conclusions: </strong>In this report, we show that awake pronation is possible in patients with subarachnoid hemorrhage. However, careful monitoring of Intracranial pressure and clinical examination may be the keys to successful application of this procedure.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"255"},"PeriodicalIF":0.9,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173165","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}

{"title":"Robotic-assisted tendon transplantation-approach for pelvic organ prolapse repair: a case report.","authors":"Dominique Koensgen, Charlotte Lukannek, Carolin Schroeder, Lucia A Otten, Amadeus Hornemann, Alexander Mustea","doi":"10.1186/s13256-025-05267-2","DOIUrl":"10.1186/s13256-025-05267-2","url":null,"abstract":"<p><strong>Background: </strong>The management of pelvic organ prolapse remains a clinical challenge, particularly with concerns regarding the safety of synthetic mesh-based procedures. In response, we present a novel approach for apical prolapse repair utilizing robotic assistance for tendon transplantation, offering a promising alternative to the use of synthetic meshes.</p><p><strong>Case presentation: </strong>A 47-year-old multiparous woman (white, non-Hispanic) with a history of three vaginal deliveries and laparoscopic supracervical hysterectomy presented with symptoms of pelvic organ prolapse, including vaginal discomfort, recurrent urinary tract infections, and overactive bladder. Clinical examination and ultrasonography revealed a combined anterior and apical vaginal prolapse grade II according to the Pelvic Organ Prolapse Quantification system. A robotic sacrocervicopexy with a semitendinosus autograft, harvested from the left popliteal fossa, and concomitant anterior colporrhaphy were performed. The surgical procedure included the dissection of the ligamentum longitudinale using a nerve-sparing technique, cervix preparation, and tendon transplantation. The surgery lasted 172 min without intraoperative complications. The patient's postoperative recovery was swift without residual prolapse, voiding dysfunction, or urinary incontinence reported at any of the follow-up examinations, conducted at 8 weeks, 3 months, 6 months, and 1 year after the operation.</p><p><strong>Conclusion: </strong>This case report demonstrates the successful application of a robotic-assisted tendon transplantation approach for apical prolapse repair, offering a safe and effective alternative to synthetic mesh-based surgical procedures. An ongoing multicenter registry study aims to further validate the method's safety and efficacy, paving the way for its broader adoption in clinical practice.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"253"},"PeriodicalIF":0.9,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12108028/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144150650","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}

{"title":"Presentation of acanthosis nigricans as scalp papillomatosis: a case report.","authors":"Fatemeh Mohaghegh, Mohammad Shoushtarizadeh, Masha Bahraminejad, Elham Tavousi Tabatabaei, Zahra Talebzadeh","doi":"10.1186/s13256-025-05315-x","DOIUrl":"10.1186/s13256-025-05315-x","url":null,"abstract":"<p><strong>Background: </strong>Acanthosis nigricans is a skin condition characterized by dark, thickened plaques, typically found in intertriginous regions such as the groin and neck. While commonly associated with obesity and insulin resistance, acanthosis nigricans rarely presents on the scalp. This case report highlights an uncommon presentation of acanthosis nigricans.</p><p><strong>Case presentation: </strong>A 16-year-old Iranian male presented with yellowish-brown, scaly papillomatous plaques on the scalp, along with velvety brown plaques in flexural areas. He had a longstanding history of seborrheic dermatitis on the frontal scalp, which had worsened with weight gain and obesity. Otherwise, the patient was healthy. Histopathological examination revealed papillomatosis, hyperkeratosis, and acanthosis. Despite thorough evaluation for systemic diseases, the diagnosis of acanthosis nigricans was confirmed on the basis of lesions observed on other regions of the body. The patient was treated with keratolytic therapy and advised on weight reduction, leading to significant improvement within 2 months.</p><p><strong>Conclusion: </strong>While acanthosis nigricans typically manifests in the skin folds, this case highlights the importance of considering acanthosis nigricans as a differential diagnosis in patients with scalp involvement, particularly those with obesity and insulin resistance. Histopathological confirmation remains essential, and management should focus on addressing the underlying etiological factors, as demonstrated by the favorable outcomes achieved through keratolytic therapy and weight management in this patient.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"252"},"PeriodicalIF":0.9,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142732","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}

{"title":"Recurrent ovarian inguinal hernia complicated with Mayer-Rokitansky-Küster-Hauser syndrome: a case report.","authors":"Weichao Liang, Qisheng Chen, Yihao Ma, Yingchang Zhu","doi":"10.1186/s13256-025-05262-7","DOIUrl":"10.1186/s13256-025-05262-7","url":null,"abstract":"<p><strong>Background: </strong>Herniation of female genital organs complicated by Mayer-Rokitansky-Küster-Hauser syndrome in adolescents is rarely reported in previous studies, and delayed diagnosis or misdiagnosis of this situation can lead to serious injury.</p><p><strong>Case presentation: </strong>Herein, we report a 13-year-old Chinese female patient who presented with a recurrent left inguinal mass. The patient was diagnosed with herniation of the uterus, ovaries, and fallopian tubes into the inguinal canal complicated by adolescent Mayer-Rokitansky-Küster-Hauser syndrome. We provide anatomic, diagnostic, and therapeutic considerations for this rare phenomenon. The malformed uterus, ovaries, and fallopian tubes were returned to the abdominal cavity using the Bassini technique for inguinal hernia. No intraoperative or postoperative complications were reported, and the patient made a good postoperative recovery.</p><p><strong>Conclusion: </strong>This study highlights the coexistence of Mayer-Rokitansky-Küster-Hauser syndrome with inguinal hernia. Early and accurate diagnosis is crucial for successful intervention. Individualized surgical and follow-up strategies play a key role in optimizing both physical and mental recovery.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"251"},"PeriodicalIF":0.9,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103755/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142735","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}

{"title":"Microapical surgery of a periapical cyst caused by apical ramification: a case report and review of the literature.","authors":"Liyun Bai, Na Hu, Qin Yang, Dongquan Pu, Xiaoqian Feng, Yiyun Yue, Weiwei Xiao, Rui Liu, Li Liu, Xia Zhou","doi":"10.1186/s13256-025-05234-x","DOIUrl":"10.1186/s13256-025-05234-x","url":null,"abstract":"<p><strong>Background: </strong>The destruction of tooth apical bone mainly comes from odontogenic apical cysts caused by pulp necrosis, chronic inflammation, or trauma. Some affected teeth can be cured by modern root canal treatment or non-surgical retreatment, but some affected teeth do not heal after treatment. Apical surgery should be considered when root canal therapy has failed, root canal retreatment through the crown channel is difficult, or true cysts are present. This article explores the use of microapical surgery to treat a periapical cyst caused by apical ramification, emphasizing a minimal surgical approach for this lesion.</p><p><strong>Case presentation: </strong>A 47-year-old female (Han nationality) presented with a chief complaint of recurrent buccal mucosal fistula in their maxillary posterior teeth for 1 year. Clinical examination revealed a porcelain-fused-metal crown of the maxilla of the left second premolar (tooth 25) and buccal mucosa fistula. X-ray assessment showed a high-density shadow in the root canal and low-density transmission from the root apex to the middle third of distal root surface. Microscopic apical surgery was performed under local anesthesia. The apical ramification was exposed and a root apex of 3 mm was cut off. Then the apical foramen of buccal root canal, palatal root canal, and apical ramification were filled retrogradely with mineral trioxide aggregate, and finally sewn up. Follow-up X-ray at postoperative 12 months and 24 months showed that the bone density of the root apex and distal root surface was higher compared with the values measured immediately after operation. There were no clinical symptoms, and normal mucosa.</p><p><strong>Conclusion: </strong>The patient presented with a recurrent buccal mucosal fistula in the maxillary left second premolar. Microscopic apical surgery was performed under local anesthesia. After minimally invasive surgery, apical resection, inverted preparation, and mineral trioxide aggregate treatment, at postoperative 24 months, the outcome was satisfactory, with recovered apical bone, normal mucosa, and no clinical symptoms. For periapical cysts, X-ray and cone-beam computed tomography images should be read carefully before the operation. The semicircular low-density transmission image around the apical sidewall indicates the apical ramification, and that root canal treatment or microapical surgery should be performed. The operating microscope enhances visibility and provides the surgeon with a better understanding of canal anatomy, a better surgical view, and the ability to undertake more complex but predictable apical resection techniques.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"249"},"PeriodicalIF":0.9,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12100992/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132142","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}

{"title":"Uterine arteriovenous malformation or uterine artery pseudoaneurysm secondary to uterine aspiration in cesarean scar ectopic pregnancy: a case report and review of the literature.","authors":"Ngoc Diep Le, Phuc Nhon Nguyen","doi":"10.1186/s13256-025-05312-0","DOIUrl":"10.1186/s13256-025-05312-0","url":null,"abstract":"<p><strong>Introduction: </strong>Uterine arteriovenous malformation or uterine artery pseudoaneurysm after the treatment of cesarean scar ectopic pregnancy is a scarce entity, leading to potentially life-threatening conditions due to the massive bleeding. The management remains significantly crucial. Herein, we report an uncommon case with surgical management of such a rare condition at our center.</p><p><strong>Presentation case: </strong>A 31-year-old Vietnamese female patient (gravida 2, para 1) was hospitalized for cesarean scar pregnancy. The uterine aspiration was well performed. However, the woman was readmitted for an abnormally persistent hypervascularity at the site of cesarean scar ectopic pregnancy under repeated ultrasound scans. After counseling, arteriovenous malformation was suspected more, whereas uterine pseudoaneurysm was incompletely ruled out. Initially, gonadotropin-releasing hormone agonist was administered, with two doses of 37.5 mg. Later, the patient underwent laparoscopic intervention to suture the vascular proliferation mass to prevent spontaneous rupture. The surgery was achieved successfully. One more dose of gonadotropin-releasing hormone agonist was added. The ultrasound detected no existing lesion compared with previous ultrasonic imaging and serum beta-human chorionic gonadotropin declined to a negative value. The patient was monitored in 1 month uneventfully.</p><p><strong>Conclusion: </strong>A high index of suspicion of uterine arteriovenous malformation or uterine artery pseudoaneurysm should be raised after uterine curettage of cesarean scar ectopic pregnancy. Ultrasound scan is still a pivotal first-line tool in assessing this abnormality. Laparoscopic surgery with compressing suture of the enhanced myometrial vascularity/arteriovenous malformation combined with administration of gonadotropin-releasing hormone agonist may be applied. This surgical approach has not been reported before, which makes our case report unique. Further cases are required for this rare entity so as to ensure patient safety.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"248"},"PeriodicalIF":0.9,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132431","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}

{"title":"Transradial retrograde percutaneous coronary intervention of chronic total occlusion using a single guiding catheter: a case report.","authors":"Georgi Goranov, Petko Petrov","doi":"10.1186/s13256-025-05313-z","DOIUrl":"10.1186/s13256-025-05313-z","url":null,"abstract":"<p><strong>Background: </strong>With the development of specialized equipment and the retrograde technique, success rates for percutaneous coronary intervention of chronic total occlusions have increased from 60 to 90% in the past 10 years. Performing percutaneous coronary intervention via a collateral channel from the contralateral artery, using two guiding catheters, is usually the preferred approach to retrograde chronic total occlusion-percutaneous coronary intervention. In the case described in this report, we performed successful retrograde revascularization of chronic total occlusion of dominant left circumflex artery via the ipsilateral septal collateral artery from the left anterior descending artery. The procedure was performed successfully through radial artery access using a single guiding catheter. An 85-year-old white Bulgarian Caucasian male patient, with a history of lateral and inferior myocardial infarction 20 years ago and previous percutaneous coronary intervention, underwent a planned coronary arteriography owing to his complaints of typical angina symptoms. Coronary angiography revealed three-vessel coronary artery disease with patent implanted drug-eluting stents in the mid-left anterior descending artery and in the proximal right coronary artery and chronic total occlusion of dominant left circumflex artery. A septal branch in the midsegment of left anterior descending artery was supplying the distal left circumflex artery retrogradely. After repeated failed attempts at antegrade percutaneous coronary intervention for the left circumflex artery's chronic total occlusion, the retrograde approach was tried. This intervention finally succeeded through the ipsilateral septal collateral. It was performed via a single radial artery access throughout the whole process. Postoperatively, the patient had no complications and was stable at the 6-month follow-up.</p><p><strong>Conclusion: </strong>The transradial approach to retrograde percutaneous coronary intervention for chronic total occlusions via an ipsilateral septal collateral using a single guiding catheter is feasible and safe in appropriately selected cases.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"247"},"PeriodicalIF":0.9,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132429","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}