Call for CASES Leszek D. Stachaczyk, MD Pawel Buszman, MD, FESC, FSCAI American Heart of Poland, Ustroñ, Poland & CCU, Upper-Silesian Center of Cardiology,

Slides:

Advertisements

Similar presentations

INTERVENTIONAL CARDIOLOGY AN OVERVIEW

Advertisements

Marek Kondys, MD Paweł Buszman, MD, FESC, FACC

Management of LCA-LM dissection.

Call for CASES Motaz AbuSamra Krzysztof Milewski CCU, Upper-Silesian Center of Cardiology, Silesian Medical School, Katowice, Poland Head of Department:

Multivessel PCI procedure complicated with fracture of the wire Marcin D ę binski, MD Head: Pawel E. Buszman, MD, FACC University Hospital of Silesia,

ISCHAEMIC HEART DISEASE Acute Coronary Syndromes JD Marx Department of Cardiology University of the Free State.

A PROSPECTIVE MULTICENTRE REGISTRY FOR THE ASSESSMENT OF SAFETY AND EFFICACY OF BIODEGRADABLE POLYMER COATED, PACLITAXEL ELUTING STENT LUC TM * *(BALTON,

HEAPHY 1 & 2 CASE RACE 1 – DIAG Rowena OLIVER Sat 31 st Aug 2013 Session 3 / CR1-6 13:26 – 13:30 OTAGO / SOUTHLAND ABSTRACT A case of a 81 year old female.

Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery 2007 ACC/AHA and 2009 ESC GUIDELINES.

University Medical Center Groningen Thrombus aspiration during primary PCI FZ Thrombus Aspiration during Percutaneous coronary intervention in Acute.

Call for CASES One Stage Coronary And Peripheral Intervention (OCAPI) in a patient with accelerated diffuse atherosclerosis after chest irradiation. One.

Ischemic heart disease. Indications and methods of surgical treatment. Surgery department №2.

Call for CASES Staged PCI in a patient with multivessel coronary disease disqualified from CABG. Pawel Buszman, MD, FESC, FSCAI Marcin Debinski, MD Krzysztof.

One stage coronary and peripheral intervention Pawel Buszman, MD, American Heart of Poland, Ustron Silesian Medical School, Katowice.

Aspirin Plus Coumarin Versus Aspirin Alone in the Prevention of Reocclusion After Fibrinolysis for Acute Myocardial Infarction Results of the Antithrombotics.

Chaim Lotan MD, Yaron Almagor MD, Karel Kuiper MD, M.J. Suttorp MD, William Wijns MD The SICTO Study CYPHER TM Sirolimus-eluting stent in Chronic Total.

C. Graidis, D. Dimitriadis, A. Ntatsios, V. Karasavvides

Percutaneous closure of a coronary fistula Pawel Buszman, MD Silesian Medical School Katowice, Poland.

SCAAR UCR SWEDEN 2007 Stefan James, Jörg Carlsson, Johan Lindbäck, Tage Nilsson, Ulf Stenestrand, Lars Wallentin and Bo Lagerqvist for the SCAAR study.

Ischemic heart disease Basic Science 3/15/06. All of the following concerning coronary artery anatomy are correct except: The left main coronary artery.

Unstable angina and arterial hypertension Leszek Kinasz, MD American Heart of Poland Ustron, Poland.

VULNERABLE PLAQUES: Pertinent doubts and solutions in interventional cardiology EuroPCR Paris, 16 May 2006.

Call for CASES Silesian Medical School, Katowice, Poland Percutenous Controlled Reperfusion For STEMI P iotr P. Buszman.

In search of lost time: modern treatment of acute myocardial infarction. Paweł Buszman, MD, FESC, FACC Upper Silesian Heart Center Katowice, Poland Snowmass,

IVUS evaluation TAP technology for unprotected left main bifurcation lesions interventional therapy Yong-Sheng Ke. MD Department of Cardiology, Yijishan.

One patient, two years, three choices, four PCI ZHAO Peng Cardiology ， the Affiliated Hospital of Medical College of CPAPF, Tianjin, China.

Occluded Artery Trial (OAT) Presented at The American Heart Association Scientific Session 2006 Presented by Dr. Judith S. Hochman OAT Trial.

Biodegradable Polymer-Coated Sirolimus- Eluting Stent Implantation in AMI A Clinical and Angiographic Study General Hospital of Chinese People’s.

Left Main Trifurcation Disease: Early and Long-Term Outcomes Of Percutaneous Coronary Intervention I.Sheiban, A.Gerasimou, F. Sciuto, P.Omedè, G. Biondi.

Endovascular treatment on tandem lesions of cranial arteries Xiao-Long Zhang, MD, PhD Department of Radiology Huashan Hospital,Fudan University Shanghai.

LONG-TERM OUTCOMES OF PERCUTANEOUS CORONARY INTERVENTION FOR UNPROTECTED LEFT MAIN CORONARY ARTERY DISEASE: INITIAL CLINICAL EXPERIENCE. Graidis Ch. 1,

Range & Specifications CASE #1: 80% stenosis of the left renal artery located at the ostium of the vessel. HELIOS 6x13.

2009 CIT CASE REVIEW Li Weijie Department of Cardiovascular Medicine, Xijing Hospital.

PRACTICAL RECOMMENDATIONS ON ANTI- THROMBOTIC TREATMENT IN PATIENTS TREATED WITH DRUG-ELUTING STENTS Giuseppe Biondi-Zoccai Ospedale S. Giovanni Battista.

ADMIRALADMIRAL Abciximab before Direct Angioplasty and Stenting in Myocardial Infarction Regarding Acute and Long term follow-up ADMIRAL Study ADMIRAL.

New strategies and perfusion/aspiration devices for primary PCI Sandra Garcia Cruset, PhD. Cordynamic B.U. Marketing Manager.

Late Open Artery Hypothesis Jason S. Finkelstein, M.D. Tulane University Medical Center 2/24/03.

? What more will it take to turn the tide of treatment for angina patients from a PCI-first to an optimal medical therapy– first approach? 1.

Effect of Intravascular Ultrasound- Guided vs. Angiography-Guided Everolimus-Eluting Stent Implantation: the IVUS-XPL Randomized Clinical Trial Myeong-Ki.

The SAFER Trial Evaluation of the Clinical Safety and Efficacy of the PercuSurge GuardWire in Saphenous Vein Graft Intervention As presented at TCT 2000.

Columbia University Medical Center Cardiovascular Research Foundation New York City, NY Akiko Maehara, MD Use of IVUS Reduces Stent Thrombosis and Myocardial.

Cardioprotective Effects of Postconditioning in Patients Treated with Primary PCI Evaluated with Magnetic Resonance Jacob T Lønborg Niels Vejlstrup, Erik.

J Am Coll Cardiol 2008;51:538–45 Acute and Late Outcomes of Unprotected Left Main Stenting in Comparison With Surgical Revascularization Pawel E. Buszman,

End points in PTCA trials. A successful angioplasty is defined as the reduction of a minimum stenosis diameter to

Date of download: 9/17/2016 Copyright © The American College of Cardiology. All rights reserved. From: 2014 AHA/ACC Guideline for the Management of Patients.

Date of download: 9/18/2016 Copyright © The American College of Cardiology. All rights reserved. From: Percutaneous Treatment of Protected and Unprotected.

Seminar #5 – Cardiovascular Conditions Deborah A. Balentine, M.Ed., RHIA, CCS-P Kaplan University.

From: Bivalirudin Versus Heparin With or Without Glycoprotein IIb/IIIa Inhibitors in Patients With STEMI Undergoing Primary Percutaneous Coronary Intervention:

ISCHEMIC HEART DISEASE

Adel Gamal, MD and Mohamed Saber, Msc

Successful transdradial removal of a dislodged coronary stent

Special Hospital for surgical diseases “Filip Vtori”, Skopje

Fig. 1. Initial coronary angiography reveals 70% narrowing of proximal LAD (A) and the stenosis is persistent after intracoronary nitrates administration.

Tarek Abou Ghazala, MD, FACC, FSCAI

Zeeshan Khan, MD Second Year Cardiology Fellow

Percutaneous Closure of a Coronary Fistula

Meruzhan Saghatelyan, MD, Interventional cardiologist

The Winking Saphenous Vein Graft: Acute Aorto-Vein Graft Anastomotic Torsional Kink causing Dynamic Systolic Compression Complicating Vein Graft PCI Dr.

Catheter-Based Treatment of Coronary Artery Disease

R. Jay Widmer, MD, PhD, Peter M. Pollak, MD, Malcolm R

Advances in Interventional Cardiology

Glenn N. Levine et al. JACC 2016;68:

Figure 1 PCI strategies in patients with STEMI and multivessel disease

Bailout emergency stenting of unprotected ostial left main coronary artery for acute catheter-induced occlusion during diagnostic coronary angiography

Incidence and management of restenosis after treatment of unprotected left main disease with drug-eluting stents: 70 restenotic cases from a cohort of.

Percutaneous revascularization strategies in a patient with previous coronary artery bypass surgery: Technical and patho-physiological insights Pierfrancesco.

Presented at TCT 2006.

Maintenance of Long-Term Clinical Benefit with

Train-the-Trainer Cases

R. Jay Widmer, MD, PhD, Peter M. Pollak, MD, Malcolm R

Presentation transcript:

Call for CASES Leszek D. Stachaczyk, MD Pawel Buszman, MD, FESC, FSCAI American Heart of Poland, Ustroñ, Poland & CCU, Upper-Silesian Center of Cardiology, Silesian Medical School, Katowice, Poland Leszek D. Stachaczyk, MD Pawel Buszman, MD, FESC, FSCAI American Heart of Poland, Ustroñ, Poland & CCU, Upper-Silesian Center of Cardiology, Silesian Medical School, Katowice, Poland Percutaneous closure of coronary artery aneurysm: long term implication Percutaneous closure of coronary artery aneurysm: long term implication

Introduction Atherosclerosis of coronary artery may result in lumen narrowing or anurysm formation. Coronary anurysm enhances the risk of local thrombosis and/or peripheral embolisation. There is no established treatment for large coronary aneurysms. Atherosclerosis of coronary artery may result in lumen narrowing or anurysm formation. Coronary anurysm enhances the risk of local thrombosis and/or peripheral embolisation. There is no established treatment for large coronary aneurysms.

Age 47 / male Symptoms: Unstable Angina. Medical History: non-Q myocardial infarction in Risk factors: Hypercholesterolaemia, ex-smoker. Age 47 / male Symptoms: Unstable Angina. Medical History: non-Q myocardial infarction in Risk factors: Hypercholesterolaemia, ex-smoker. Description of the problem Case report:

Description of the problem Concomitant treatment of coronary artery stenosis and aneurysm.Concomitant treatment of coronary artery stenosis and aneurysm. Percutaneous closure of left anterior descending coronary artery aneurysm with stent graft.Percutaneous closure of left anterior descending coronary artery aneurysm with stent graft. Concomitant treatment of coronary artery stenosis and aneurysm.Concomitant treatment of coronary artery stenosis and aneurysm. Percutaneous closure of left anterior descending coronary artery aneurysm with stent graft.Percutaneous closure of left anterior descending coronary artery aneurysm with stent graft.

Left anterior descending coronary artery aneurysm. LCA: RAO 30 Coronary angiography: LCA: LM-short, without narrowing LAD-proximal aneurysm (diam. ca 5-6mm), critical narrowings in med segment (90 and 75%) Cx-50-60% lesion in med segment. RCA: dominant, normal.

Intended strategy Guiding catheter: Judkins Left 4, 7F Stent graft Jostent 3.0x16mm on balloon 3.5x20mm Quantuum Predilatation of LAD and placement of a PTFE – covered stent Direct stenting to med Cx Guiding catheter: Judkins Left 4, 7F Stent graft Jostent 3.0x16mm on balloon 3.5x20mm Quantuum Predilatation of LAD and placement of a PTFE – covered stent Direct stenting to med Cx Technical data:

Stenting Administration of ticlopidine and ASA 2 days before procedure Routine anticoagulation during procedure. Predilatation and stent implantation to LAD (3.0 / 16mm Jostent coronary stent graft with 16 atm) Direct stenting to med Cx Administration of ticlopidine and ASA 2 days before procedure Routine anticoagulation during procedure. Predilatation and stent implantation to LAD (3.0 / 16mm Jostent coronary stent graft with 16 atm) Direct stenting to med Cx

Acute Result TIMI 3 flow after stent implantation Non significant residual stenosis No complication TIMI 3 flow after stent implantation Non significant residual stenosis No complication

Long-term sequel Acute MI after 6 months (late in-stent thrombosis) Successful thrombolysis combined with IIb/IIIa inhibitor. Acute MI after 6 months (late in-stent thrombosis) Successful thrombolysis combined with IIb/IIIa inhibitor.

Summary A 47 year old male with unstable angina was addmitted to the hospital for interventional diagnosis and treatment. Coronary angiography showed a LAD eccentric aneurysm and double-vessel coronary artery disease (LAD, Cx). The aneurysm and the lesion in proximal portion of LAD were treated with stent graft. The lesion more distally was treated with balloon angioplasty. Lesion in the Cx was stented. Patient left hospital on combined antiplatelet therapy with aspirin and ticlopidine ordered for 3 months. After 6 months patient suffered from anterior AMI caused by late in-stent thrombosis, which was successfully treated with thrombolysis and IIb/IIIa inhibitor. A 47 year old male with unstable angina was addmitted to the hospital for interventional diagnosis and treatment. Coronary angiography showed a LAD eccentric aneurysm and double-vessel coronary artery disease (LAD, Cx). The aneurysm and the lesion in proximal portion of LAD were treated with stent graft. The lesion more distally was treated with balloon angioplasty. Lesion in the Cx was stented. Patient left hospital on combined antiplatelet therapy with aspirin and ticlopidine ordered for 3 months. After 6 months patient suffered from anterior AMI caused by late in-stent thrombosis, which was successfully treated with thrombolysis and IIb/IIIa inhibitor.

Message Percutaneous coronary aneurysm closure with Jostent Graft is feasible and efficient. The use of this stent requires an extended course of double antiplatelet therapy. Percutaneous coronary aneurysm closure with Jostent Graft is feasible and efficient. The use of this stent requires an extended course of double antiplatelet therapy.