3.Initial clinical experience of intracoronary coil (Gianturco-Roubin) stents for management of acute dissection after balloon angioplasty.
Won Heum SHIM ; Jong Won HA ; Seung Yun CHO ; Si Hoon PARK ; Han Soo KIM ; Yang Soo JANG ; Namsik CHUNG ; Sung Soon KIM
Yonsei Medical Journal 1994;35(3):320-328
Dissections after percutaneous transluminal coronary angioplasty (PTCA) are risk factors for acute or subacute vessel closures. Intracoronary stenting was developed to avoid these complications by pressing the intimal and medial flaps against the vessel wall, thus reducing the risk of acute closure from thrombus formation. Thirty three coil (Gianturco-Roubin) stents were implanted into the coronary arteries of 32 patients with dissections after PTCA during the period of March 1993 to December 1993. The indications for stent implantation were acute closure in 6 (18.8%), threatened closure in 6 (18.8%) and suboptimal result in 20 (62.4%) patients. Stent insertion were successful in 30 (94%) patients. The diameter stenosis in an immediate angiographic findings after stenting was decreased from 87% to 18% by caliper estimation. Emergency coronary artery bypass graft surgery was required in 1 (3%) patient. A non-Q wave myocardial infarction occurred in 1 (3%) patient. Complications included hematoma of the arterial access site requiring blood transfusion in 4 (12.5%) patients and hemopericardium in 1 (3%) patient. Our initial clinical experience of flexible coil coronary stent imply that stenting is efficacious treatment for acute dissections that are causing acute or threatened closure following angioplasty. The long term follow-up result in all groups of patient who received coronary stents is needed for better evaluation of new devices and prognosis.
Acute Disease
;
Adult
;
Aged
;
Aneurysm, Dissecting/etiology/*therapy
;
Angioplasty, Transluminal, Percutaneous Coronary/*adverse effects
;
Coronary Aneurysm/etiology/*therapy
;
*Coronary Vessels
;
Female
;
Human
;
Male
;
Middle Age
;
*Stents
5.Acute Myocardial Infarction Caused by Coronary Artery Dissection Following Blunt Chest Trauma.
Se Jung YOON ; Hyuck Moon KWON ; Dong Soo KIM ; Bum Kee HONG ; Dong Yeon KIM ; Yun Hyeong CHO ; Byung Seung KANG ; Hyun Seung KIM
Yonsei Medical Journal 2003;44(4):736-739
Chest trauma can lead to various cardiac complications ranging from simple arrhythmias to myocardial rupture. An acute myocardial infarction (AMI) is a rare complication that can occur after chest trauma. We report a case of 66-year-old male who suffered a blunt chest trauma from a traffic accident resulting in an AMI. The coronary angiography revealed an eccentric 50% narrowing of the ostium of left anterior descending artery (LAD) by a dissection flap with calcification. Intravascular ultrasonography (IVUS) revealed eccentric calcified plaque (minimal luminal diameter [MLD]=3.5 mm) with a dissection flap. Intervention was not performed considering the MLD and calcified flap, and he has been conservatively managed with aspirin and losartan for 2 years. The follow-up coronary angiography showed an insignificant luminal narrowing of the proximal LAD from the ostium without evidence of a dissection. An early coronary evaluation including an IVUS study should be considered for managing patients who complain of ongoing, deep-seated chest pain with elevated cardiac enzyme levels and an abnormal electrocardiogram (ECG) after a blunt chest trauma. Based on this case, some limited cases of traumatic coronary artery dissections can be healed with conservative management and result in a good prognosis.
Aged
;
Aneurysm, Dissecting/diagnosis/*etiology
;
Coronary Aneurysm/diagnosis/*etiology
;
Coronary Angiography
;
Human
;
Male
;
Myocardial Infarction/diagnosis/*etiology
;
Radiography, Thoracic
;
Thoracic Injuries/*complications
;
Ultrasonography, Interventional
;
Wounds, Nonpenetrating/*complications
Result Analysis
Print
Save
E-mail