Successful bail-out stenting of severe stenosis of the left main trunk coronary artery using guiding catheter exchange with the anchor balloon technique

Daizaburo Yanagi,Masanori Okabe,Takeshi Serikawa,Yusuke Yamamoto

doi:10.5348/ijcri-201458-ci-10015

Daizaburo Yanagi, Masanori Okabe + Show 2 more

Open Access

https://doi.org/10.5348/ijcri-201458-ci-10015

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Abstract

Introduction: trans radial intervention (trI) is less invasive. However, percutaneous coronary intervention (PcI) operators may be concerned that trans femoral approach (tFI) is better than trI according to the state of the patients, for example the patients with acute coronary syndrome (Acs) under the shock state, with severe winding subclavian artery and with the spasming radial artery. case report: We herein report a case of an unstable angina and acute heart failure. coronary angiography (cAG) revealed evidence of 90% ostial stenosis of the left main trunk (LMt). but we were unable to engage a 6 Fr guiding catheter (Gc) because of severe tortuosity of the left subclavian artery. therefore, we attempted intracoronary passage of a 4 Fr JL3.5 catheter exchange the 4 Fr diagnostic catheter with a 6 Fr Gc using an

Highlights

Trans radial intervention (TRI) is less invasive
Percutaneous coronary intervention (PCI) operators may be concerned that trans femoral approach (TFI) is better than TRI according to the state of the patients, for example the patients with acute coronary syndrome (ACS) under the shock state, with severe winding subclavian artery and with the spasming radial artery
TRI or a downsizing stenting system is essential for patients in whom the approach site is limited in size

Summary

INTRODUCTION

The transradial intervention (TRI) is increasingly used globally for coronary angiography and interventions, performing percutaneous coronary intervention (PCI) in arteries with complex anatomy remains a clinical problem. Www.ijcasereportsandimages.com and can hamper delivery of guiding catheter to coronary artery The management of these conditions remains controversial, with only a few reports in literature. After the insertion of an intra-aortic balloon pump (IABP) into the left femoral artery, we inserted a 4 French (Fr) sheath into the right radial artery. At this time, coronary angiography revealed evidence of 90% ostial stenosis of the left main trunk (LMT) (Figure 2). We attempted to continue percutaneous coronary intervention (PCI), but were unable to engage a 6 Fr guiding catheter (GC) because of severe tortuosity of the left subclavian artery. An angiography performed at the 2-month follow-up showed no recurrence of stenosis (Figure 9)

DISCUSSION

CONCLUSION