Limits...
Complete stent fracture 1 year after LIMA PCI due to LIMA and subclavian artery dissection.

Anagnostou D, Sanidas E, Paizis I, Barbetseas J - Oxf Med Case Reports (2015)

Bottom Line: Predisposing factors usually involve long lesions and tortuous vessels requiring more than one stent.This issue is magnified when it involves a periprocedural iatrogenic left internal mammary artery (LIMA) and subclavian artery dissection.We present a case of complete stent fracture 1 year after LIMA percutaneous coronary intervention due to LIMA and subclavian artery dissection highlighting the circumstantial evidence in the literature that guided our management decisions.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Cardiology , 'Laiko' General Hospital , Athens , Greece.

ABSTRACT
Stent platforms are prone to fracture while incidental data are demonstrating a potential unfavorable outcome. Predisposing factors usually involve long lesions and tortuous vessels requiring more than one stent. This issue is magnified when it involves a periprocedural iatrogenic left internal mammary artery (LIMA) and subclavian artery dissection. In such complex clinical scenarios, the risk of potential complications including stent fractures is thought to be higher, though there is no data to determine the prognosis or to outline the outcomes of any management option. We present a case of complete stent fracture 1 year after LIMA percutaneous coronary intervention due to LIMA and subclavian artery dissection highlighting the circumstantial evidence in the literature that guided our management decisions.

No MeSH data available.


Related in: MedlinePlus

(a) Subclavian artery dissection (staining contrast) and LIMA dissection during PCI. (b) Final result after two overlapping stents placement at the ostium and the proximal part of the LIMA covering the dissection. (c) Angiographic appearance of type V stent fracture at the mid portion of the distal stent 1 year after PCI. (White and black lines are indicating the proximal and distal stent edges.)
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OMV050F2: (a) Subclavian artery dissection (staining contrast) and LIMA dissection during PCI. (b) Final result after two overlapping stents placement at the ostium and the proximal part of the LIMA covering the dissection. (c) Angiographic appearance of type V stent fracture at the mid portion of the distal stent 1 year after PCI. (White and black lines are indicating the proximal and distal stent edges.)

Mentions: A 76-year-old male patient with previous history of triple coronary artery bypass graft (CABG) surgery [LIMA to left anterior descending artery (LAD), saphenous vein graft (SVG) to obtuse marginal (OM2), SVG to first diagonal (D1)] presented with episodes of angina pectoris. His coronary angiogram showed that all grafts were patent yet there was a significant stenotic lesion at the LIMA to LAD anastomosis (Fig. 1a) for which he received a 2.5 × 8 mm second-generation DES (Fig. 1b). During PCI, a dissection occurred at the proximal segment of the left subclavian artery involving the ostium and the proximal segment of the LIMA (Fig. 2a). In order to cover the LIMA dissection, two overlapping second-generation DES 3.0 × 24 mm distally and 3.0 × 12 mm proximally were placed accordingly (Fig. 2b). Conversely, the dissection of the left subclavian did not receive any intervention since the patient was asymptomatic and hemodynamically stable.Figure 1:


Complete stent fracture 1 year after LIMA PCI due to LIMA and subclavian artery dissection.

Anagnostou D, Sanidas E, Paizis I, Barbetseas J - Oxf Med Case Reports (2015)

(a) Subclavian artery dissection (staining contrast) and LIMA dissection during PCI. (b) Final result after two overlapping stents placement at the ostium and the proximal part of the LIMA covering the dissection. (c) Angiographic appearance of type V stent fracture at the mid portion of the distal stent 1 year after PCI. (White and black lines are indicating the proximal and distal stent edges.)
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4584514&req=5

OMV050F2: (a) Subclavian artery dissection (staining contrast) and LIMA dissection during PCI. (b) Final result after two overlapping stents placement at the ostium and the proximal part of the LIMA covering the dissection. (c) Angiographic appearance of type V stent fracture at the mid portion of the distal stent 1 year after PCI. (White and black lines are indicating the proximal and distal stent edges.)
Mentions: A 76-year-old male patient with previous history of triple coronary artery bypass graft (CABG) surgery [LIMA to left anterior descending artery (LAD), saphenous vein graft (SVG) to obtuse marginal (OM2), SVG to first diagonal (D1)] presented with episodes of angina pectoris. His coronary angiogram showed that all grafts were patent yet there was a significant stenotic lesion at the LIMA to LAD anastomosis (Fig. 1a) for which he received a 2.5 × 8 mm second-generation DES (Fig. 1b). During PCI, a dissection occurred at the proximal segment of the left subclavian artery involving the ostium and the proximal segment of the LIMA (Fig. 2a). In order to cover the LIMA dissection, two overlapping second-generation DES 3.0 × 24 mm distally and 3.0 × 12 mm proximally were placed accordingly (Fig. 2b). Conversely, the dissection of the left subclavian did not receive any intervention since the patient was asymptomatic and hemodynamically stable.Figure 1:

Bottom Line: Predisposing factors usually involve long lesions and tortuous vessels requiring more than one stent.This issue is magnified when it involves a periprocedural iatrogenic left internal mammary artery (LIMA) and subclavian artery dissection.We present a case of complete stent fracture 1 year after LIMA percutaneous coronary intervention due to LIMA and subclavian artery dissection highlighting the circumstantial evidence in the literature that guided our management decisions.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Cardiology , 'Laiko' General Hospital , Athens , Greece.

ABSTRACT
Stent platforms are prone to fracture while incidental data are demonstrating a potential unfavorable outcome. Predisposing factors usually involve long lesions and tortuous vessels requiring more than one stent. This issue is magnified when it involves a periprocedural iatrogenic left internal mammary artery (LIMA) and subclavian artery dissection. In such complex clinical scenarios, the risk of potential complications including stent fractures is thought to be higher, though there is no data to determine the prognosis or to outline the outcomes of any management option. We present a case of complete stent fracture 1 year after LIMA percutaneous coronary intervention due to LIMA and subclavian artery dissection highlighting the circumstantial evidence in the literature that guided our management decisions.

No MeSH data available.


Related in: MedlinePlus