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Takayuki Warisawa, Toru Naganuma, Sunao Nakamura
We report a case of percutaneous coronary intervention in a bifurcation lesion involving left circumflex (LCx) artery and 2 major posterolateral (PL) arteries. The target LCx had diffuse long and severely calcified lesion with the acute takeoff angle from the left main. Despite adequate lesion preparation with rotational atherectomy and balloon angioplasty, the stent was not deliverable, even with deep intubation of 7Fr-guiding catheter. Conventional use of guiding extension catheter (GEC) would have required removal of a wire from at least one PL because of the device interference in the GEC...
October 18, 2016: Cardiovascular Intervention and Therapeutics
Chairat Burusapat, Tirapat Nanasilp, Paiboon Kunaphensaeng, Anuchit Ruamthanthong
: The anterolateral thigh (ALT) flap has been widely used for reconstructions. Nevertheless, the atherosclerotic risk factors that affect the lateral circumflex femoral artery (LCFA) are still inconclusive. The aim was to study the effect of atherosclerosis on the LCFA and descending branch (dLCFA) visualized by computer tomographic angiography (CTA) between nonatherosclerosis and atherosclerosis. METHODS: Retrospective studies of CTA of lower extremity were reviewed...
September 2016: Plastic and Reconstructive Surgery. Global Open
Pedro A Villablanca, David F Briceno, Anand D Jagannath, Martin Cohen, Robert Pyo
Coronary vasospasm is uncommon during pregnancy and the postpartum period. We present a very rare case of an acute coronary vasospasm in a 36-year-old woman who was two weeks postpartum. The coronary arteriograms showed a coronary vasospasm in the distal left anterior descending and circumflex coronary arteries. Electrocardiogram (ECG) presentation was atypical, with T-wave inversions in leads I, aVL, and V2 to V6. To our knowledge, this is the first case with a well-documented coronary artery vasospasm in a postpartum woman without the classic ST elevation on ECG...
October 18, 2016: Acute Cardiac Care
George Jose Valooran, Shiv Kumar Nair, Krishnan Chandrasekharan
The metabolically active endothelium of arterial grafts is reported to slow the atherosclerotic process in the distal coronary territories to which they are grafted with improved patency. The literature on arterial grafting causing proximal plaque regression is scant. We report here a case of proximal left anterior descending artery (LAD) plaque regression following distal arterial grafting with a left internal mammary arterial (LIMA) graft to LAD. This rarely documented regression resulted in "stringing" of the arterial graft, while there was a significant progression of atherosclerotic disease in the right coronary with patent venous graft and de novo lesion in circumflex territory necessitating percutaneous coronary intervention, in spite of aggressive medical therapy...
September 2016: Indian Heart Journal
Adithya Udupa, B K Goyal, Sameer Pagad
Hyperdominant left anterior descending artery (LAD) is a rare coronary anomaly in which posterior descending artery arises from LAD instead of left circumflex or right coronary artery. Here we present a case of hyperdominant LAD presenting as acute myocardial infarction.
September 2016: Indian Heart Journal
S Thrudeep, George Geofi, George Rupesh, S Abdulkhadar
Acute coronary syndrome (ACS) and electrocardiography showing ST elevation in Lead aVR>V1 are considered specific for left main coronary artery lesion and also suggest extensive anterior wall myocardial infarction. In this backdrop, we are presenting an incidental observation of an association of ST elevation in lead aVR>V1 in isolated proximal left circumflex lesion in the setting of ACS, who later underwent successful primary percutaneous coronary intervention.
September 2016: Indian Heart Journal
P Vinodh Kumar, Asha Moorthy
A 38-year-old man presented with exertional angina of 1-year duration. Treadmill was strongly positive. Coronary angiogram revealed a significant phasic systolic compression of the left main and the proximal left circumflex artery. Echo and MRI revealed a subaortic left ventricle diverticulum causing compression of the coronary vessels. Before the planned surgery, the patient had sudden deterioration with cardiogenic shock and could not be saved.
September 2016: Indian Heart Journal
Ana Blasco, Carmen Bellas, Leyre Goicolea, Ana Muñiz, Víctor Abraira, Ana Royuela, Susana Mingo, Juan Francisco Oteo, Arturo García-Touchard, Francisco Javier Goicolea
INTRODUCTION AND OBJECTIVES: Thrombus aspiration allows analysis of intracoronary material in patients with ST-segment elevation myocardial infarction. Our objective was to characterize this material by immunohistology and to study its possible association with patient progress. METHODS: This study analyzed a prospective cohort of 142 patients undergoing primary angioplasty with positive coronary aspiration. Histological examination of aspirated samples included immunohistochemistry stains for the detection of plaque fragments...
October 10, 2016: Revista Española de Cardiología
Faten M'hiri, Luc Duong, Christian Desrosiers, Mohamed Leye, Joaquim Miró, Mohamed Cheriet
The segmentation and tracking of coronary arteries (CAs) are critical steps for the computation of biophysical measurements in pediatric interventional cardiology. In the literature, most methods are focused on either segmenting the vessel lumen or on tracking the vessel centerline. However, they do not simultaneously combine the segmentation and tracking of a specific CA. This paper introduces a novel algorithm for CA segmentation and tracking from 2D X-ray angiography sequences. The proposed algorithm is based on the Temporal Vessel Walker (TVW) segmentation method, which combines graph-based formulation and temporal priors...
October 4, 2016: Computers in Biology and Medicine
Deepak Kumar Mishra, Shalima Gautam, B K Goyal, Ramesh Kawar
Coronary cameral fistulae are rare and bicoronary pulmonary artery fistulae is even rarer. This is a case of a 70 year old male who presented to us with complaints of chest pain and dyspnoea. His ECG showed ST-T changes in inferior and anterior precordial leads suggestive of ischaemia in those territories. His coronary angiogram revealed bilateral coronary pulmonary arterial fistulae arising from left circumflex and right coronary artery and draining into pulmonary artery without any atherosclerotic narrowing of coronaries...
May 2016: Journal of the Association of Physicians of India
Ravi Varshney, Matthew Chamberlain, Erin Rayner-Hartley, Edel Kelliher, Arthur Lee, Richard Cook, Anthony Fung, Kenneth Gin, Parvathy Nair, Teresa S M Tsang
Formation of an intramural left atrial hematoma (ILAH) is a rare complication of coronary artery stenting. Rapid diagnosis with noninvasive multimodality imaging can potentially be lifesaving. We report a case of ILAH that resulted in left ventricular inflow obstruction and pericardial tamponade in a 55-year-old male who presented with hemodynamic instability and worsening dyspnea three weeks after seemingly uncomplicated left circumflex artery stenting. We demonstrate features on transthoracic echocardiography with contrast and cardiac computed tomography that were used for diagnosis and management...
October 13, 2016: Echocardiography
Lijie Zhu, Jingjing Liu, Chuanyu Gao, Wenli Zhao, Jing Que, Xianpei Wang, Datun Qi, Jun Liu, Wentao Xiao, Juanjuan Yan, Wentao Li, You Zhang, Honghui Yang
OBJECTIVE: Diabetes substantially increases the risk of cardiovascular disease (CAD) and is associated with an increased risk of CAD mortality. The purpose of this study was to investigate the differences in coronary artery plaque, coronary artery calcification (CAC) measured in outpatients with and without type 2 diabetes, and the occurrence rate of a major adverse cardiac event (MACE) throughout follow-up with the same patients. METHODS: Five hundred eighty-eight outpatients with suspected CAD comprising 208 diabetic and 380 non-diabetic patients were enrolled in this study...
2016: SpringerPlus
Tobias Heer, Stephanie Reiter, Markus Trißler, Berthold Höfling, Florian von Knobelsdorff-Brenkenhoff, Günter Pilz
PURPOSE: To systematically investigate the effect of sublingual glyceryl trinitrate (nitroglycerin=nitro=glyceryl trinitrate=GTN=C3 H5 N3 O9 [NTG]) on the diagnostic performance of MR coronary artery imaging (MRCA) to detect relevant coronary artery disease (CAD). MATERIALS AND METHODS: Thirty-five healthy volunteers and 25 patients with suspected or proven CAD (all in sinus rhythm) underwent MRCA before and after NTG using a contrast-agent free, three-dimensional, navigator-based, steady state free precession acquisition (voxel size 1...
October 12, 2016: Journal of Magnetic Resonance Imaging: JMRI
Mineto Ohta, Chikashi Nakanishi, Naoki Kawagishi, Yasuyuki Hara, Kai Maida, Toshiaki Kashiwadate, Koji Miyazawa, Satoru Yoshida, Shigehito Miyagi, Yukihiro Hayatsu, Shunsuke Kawamoto, Yasushi Matsuda, Yoshinori Okada, Yoshikatsu Saiki, Noriaki Ohuchi
BACKGROUND: Recurrent hepatocellular carcinoma accompanied by a right atrial tumor thrombus is rare. No standard treatment modality has been established. Surgical treatment may be the only curative treatment; however, surgery has been considered high risk. We herein describe a patient who underwent resection of a recurrent right atrial tumor thrombus under normothermic cardiopulmonary bypass on a beating heart. CASE PRESENTATION: A 60-year-old man underwent a right hepatectomy for hepatocellular carcinoma with diaphragm invasion...
December 2016: Surgical Case Reports
Tommy Wilkman, Satu Apajalahti, Erika Wilkman, Jyrki Törnwall, Patrik Lassus
PURPOSE: The aim of the present study was to compare the resorption of the bone in the free scapular, free iliac crest, and free fibular microvascular flaps in mandibular reconstruction over time. PATIENTS AND METHODS: In the present retrospective study, we analyzed 186 consecutive patients with scapular, fibular, or deep circumflex iliac artery (DCIA) osseous free microvascular flaps in mandibular reconstruction. We followed up the patients clinically and using multislice computed tomography (MSCT) with volume analyses of the bone...
September 15, 2016: Journal of Oral and Maxillofacial Surgery
Henry D De'Ath, Kathryn Oakland, Karim Brohi
BACKGROUND: Arterial calcification on Computerised Tomography (CT) is a marker of cardiovascular disease. It is predictive of future adverse cardiac events and mortality in many disease states. The incidence of arterial disease and its impact on outcomes of the injured is not known. The objectives of this study were to describe the incidence of arterial calcification in trauma patients, and establish its impact on mortality. METHODS: A retrospective cohort study of all injured patients aged over 45 years presenting to a major trauma centre over a 34-month period...
October 10, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Ioannis Dimovelis, Adamantios Michalinos, Eleftherios Spartalis, Georgios Athanasiadis, Panayiotis Skandalakis, Theodore Troupis
Anatomic variations of axillary artery branches are commonly encountered during radiological investigation and surgical operations. Their existence can confuse interpretation of radiological results and lead to undesired complications during surgery. In this report authors describe a rare case of a subscapular arterial trunk that gave origin to thoracodorsal, circumflex scapular, posterior humeral circumflex, and lateral thoracic artery. Such a variation might cause undesired sequelae during trauma management and a variety of common flap harvesting operations including latissimus dorsi, scapular and parascapular flaps...
October 7, 2016: Folia Morphologica (Warsz)
Krzysztof A Tomaszewski, Jens Vikse, Brandon M Henry, Joyeeta Roy, Przemysław A Pękala, Maren Svensen, Daniel Guay, Karolina Saganiak, Jerzy A Walocha
The lateral circumflex femoral artery is responsible for vascularization of the head and neck of the femur, greater trochanter, vastus lateralis and the knee. The origin of the lateral circumflex femoral artery has been reported to vary significantly throughout the literature, with numerous branching patterns described and variable distances to the mid-inguinal point reported. The aim of this study was to determine the estimated population prevalence and pooled means of these anatomical characteristics, and review their associated clinical relevance...
October 7, 2016: Folia Morphologica (Warsz)
Jarosław Karwowski, Lech Poloński, Marek Gierlotka, Andrzej Ciszewski, Michał Hawranek, Maciej Bęćkowski, Mariusz Gąsior, Ilona Kowalik, Hanna Szwed
BACKGROUND: Prevalence and impact of total coronary occlusion of an Infarct-Related Artery (IRA) on outcomes in patients with Non-ST-Elevation Myocardial Infarction (NSTEMI) remain unclear. AIM: We evaluated the clinical significance of total coronary occlusion in NSTEMI patients. METHODS: A total of 2767 patients with NSTEMI enrolled in the Polish Registry of Acute Coronary Syndromes who underwent percutaneous coronary interventions were analyzed...
October 7, 2016: Kardiologia Polska
Tetsuma Kawaji, Hiroki Shiomi, Takeshi Morimoto, Yutaka Furukawa, Yoshihisa Nakagawa, Kazushige Kadota, Kenji Ando, Tetsu Mizoguchi, Mitsuru Abe, Mamoru Takahashi, Takeshi Kimura
BACKGROUND: Cardiogenic shock remained the leading cause of death in ST-segment elevation acute myocardial infarction (STEMI) patients even in the primary percutaneous coronary intervention era. METHODS: Among 3942 STEMI patients with primary percutaneous coronary intervention within 24 h after symptom-onset in the Coronary Revascularization Demonstrating Outcome Study in Kyoto acute myocardial infarction registry, the study population of the current analysis consisted of 466 STEMI patients who were complicated by cardiogenic shock due to acute pump failure...
October 5, 2016: European Heart Journal. Acute Cardiovascular Care
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