Browse
Submit Data
Databases
API
Help

Dataset Information

0 Views

0 Connections

0 Citations

0 Reanalyses

0 Downloads

Omics score: 0

A bleeding kiss: intramural haematoma secondary to balloon angioplasty.

ABSTRACT:

Background

Intramural coronary haematoma following percutaneous coronary intervention in the absence of coronary dissection is a rare phenomenon.

Case presentation

A 69 year old lady with previous prosthetic aortic valve replacement underwent percutaneous coronary intervention (PCI) from the left mainstem to the left anterior descending artery (LAD) and kissing balloon inflations to the LAD and circumflex (Cx) arteries. Although intravascular ultrasound examination (IVUS) of both the LAD and Cx showed both vessels to be widely patent at the end of the procedure, she developed ischaemic chest pain six hours later. Repeat coronary angiography revealed a significant stenosis in the proximal Cx vessel, which was confirmed on IVUS to be intramural haematoma.

Conclusion

In patients taking warfarin in addition to standard antiplatelet therapy, kissing balloon inflations should be carried out with caution.

SUBMITTER: Shirodaria C

PROVIDER: S-EPMC1891271 | biostudies-literature | 2007 Jun

REPOSITORIES: biostudies-literature

ACCESS DATA

Json Xml

Publications

A bleeding kiss: intramural haematoma secondary to balloon angioplasty.

Shirodaria Cheerag C Van Gaal William J WJ Banning Adrian P AP

Cardiovascular ultrasound 20070605

<h4>Background</h4>Intramural coronary haematoma following percutaneous coronary intervention in the absence of coronary dissection is a rare phenomenon.<h4>Case presentation</h4>A 69 year old lady with previous prosthetic aortic valve replacement underwent percutaneous coronary intervention (PCI) from the left mainstem to the left anterior descending artery (LAD) and kissing balloon inflations to the LAD and circumflex (Cx) arteries. Although intravascular ultrasound examination (IVUS) of both ...[more]

PMID: 17550602

Similar Datasets

Juxtaposition of urgent angioplasty results in spontaneous coronary artery dissection: a case report of fresh vs. organized intramural haematoma.

Project description:BackgroundCoronary intramural haematoma from spontaneous coronary artery dissection (SCAD) presents as an acute coronary syndrome, usually in young or middle-aged female patients. Conservative management in the absence of ongoing symptoms is best practice, and the artery eventually heals fully.Case summaryA 49-year-old female presented with a non-ST elevation myocardial infarction. Initial angiography and intravascular ultrasound (IVUS) demonstrated typical intramural haematoma of the ostial to mid left circumflex artery. Initial conservative management was selected, but the patient developed further chest pain 5 days later and with worsening electrocardiogram changes. Further angiography was carried out demonstrating near-occlusive disease with organized thrombus in the false lumen. The angioplasty result from this is juxtaposed with another acute SCAD case on the same day with fresh intramural haematoma.DiscussionReinfarction is a common occurrence in SCAD, and little is known about how to predict it. These cases demonstrate the appearance on IVUS of fresh vs. organized thrombus and the relative angioplasty result in each case. Follow-up IVUS due to ongoing symptoms in one patient demonstrated significant stent malapposition, not apparent at the index intervention, in all likeliness due to intramural haematoma regression.

| S-EPMC10266167 | biostudies-literature

Endovascular Radial Artery Sacrifice in an Unsalvageable Transradial Access Site Bleeding due to Cutting Balloon Angioplasty.

Project description:The radial artery access site laceration is rare. We hereby described a case of radial artery access site laceration during retrieval of a cutting balloon. The bleeding site was not responsive to hemostatic maneuvers such as application of an external blood pressure cuff, balloon inflation, and an external compression bandage and was eventually coil embolized. Sacrifice using endovascular coiling averted surgical ligation which was the alternative.

| S-EPMC6600103 | biostudies-literature

Left atrial intramural haematoma: a fatal complication of cardiac amyloidosis-a case report.

Project description:BackgroundSpontaneous left atrial intramural hematoma (LAIH) is extremely rare and there are only two cases of spontaneous LAIH involving cardiac amyloidosis (CA) reported in literature. In both cases, LAIH rapidly compromised hemodynamic stability proving to be a rare yet fatal complication.Case summaryAn 83-year-old man presented with cardiogenic shock. Electrocardiogram showed complete atrioventricular block, and echocardiogram revealed severe hypokinesis and left ventricular hypertrophy. Coronary angiography revealed no significant coronary stenosis and tissue biopsy was taken from the left ventricle. The patient was intubated, placed on extracorporeal membrane oxygenation with intra-aortic balloon pump and temporary pacemaker, and admitted to ICU. Day 6 of admission, he became hemodynamically unstable, and presented with atrial fibrillation. Transesophageal echocardiography showed a newly formed large mass in the left atrium. Day 11 of admission, the patient passed away. Autopsy revealed cardiac amyloidosis and showed the mass to be a left atrial intramural hematoma. Diffuse amyloid deposits were found in the myocardium as well as the blood vessel walls of the region surrounding the LAIH.ConclusionLAIH is a rare yet fatal complication of CA. Autopsy revealed diffuse amyloid deposits within the left atrium may lead to left atrial fragility and contribute to development of LAIH. LAIH should be considered as an important differential diagnosis in the setting of a rapidly growing left atrial mass, and in hemodynamic instability in patients with CA.

| S-EPMC10035636 | biostudies-literature

Atherectomy Plus Balloon Angioplasty for Femoropopliteal Disease Compared to Balloon Angioplasty Alone: A Systematic Review and Meta-analysis.

Project description:BackgroundThe role of atherectomy in treating femoropopliteal disease has been evolving rapidly. However, the clinical efficacy and safety of adjunctive atherectomy to percutaneous balloon angioplasty (BA) (plain balloon and drug-coated BA) remains controversial. We sought to perform a meta-analysis comparing atherectomy plus balloon angioplasty (ABA) versus BA alone in treating femoropopliteal disease.MethodsWe searched PubMed, Cochrane Central Register of Clinical Trials, EMBASE, and ClinicalTrials.gov (from inception through January 10, 2022) for studies comparing ABA versus BA for femoropopliteal disease. We used a random-effects model to calculate risk ratio (RR) with 95% CIs. Target lesion revascularization (TLR), primary patency, and bailout stenting were the primary outcomes.ResultsNine studies with 699 patients were included (4 randomized and 5 retrospective studies). Compared to BA alone, the ABA group showed a significant decrease in TLR driven by nonrandomized studies (RR 0.59; 95% CI, 0.40-0.85; P = .005) and bailout stenting (RR, 0.32; 95% CI, 0.21-0.48; P < .0001). There was no significant difference in TLR when the analysis was performed including only randomized trials. There was no significant difference in the primary patency between the 2 groups (RR, 1.04; 95% CI, 0.95-1.14; P = .37).ConclusionsData from randomized trials suggest that compared with BA alone, the combination of atherectomy and BA showed no difference in TLR or primary patency. In observational studies, TLR and bailout stenting were reduced in ABA group but there was no difference in primary patency. Further studies are needed to investigate the clinical outcomes of atherectomy combined with BA in femoropopliteal lesions compared with BA alone.

| S-EPMC11308088 | biostudies-literature

A ruptured balloon shaft during an angioplasty.

Project description:We report a case of balloon shaft rupture during percutaneous coronary intervention. Although the entrapped balloon was not yet deflated when the complication occurred, we successfully retrieved it percutaneously using a trapping technique. This case described a cheap and straightforward technique of device retrieval that helped save our patient.

| S-EPMC9723256 | biostudies-literature

Fate of a coronary artery intramural haematoma complicating aortic root surgery: a case report.

Project description:BackgroundCoronary intramural haematoma (CIH) is an uncommon but potentially life-threatening complication during aortic root surgery (such as Bentall procedure). Depending on its extension it can lead to cardiogenic shock. Documented reports of this complication are lacking in literature.Case summaryIn the report we present a case of CIH and its management and we show a stepwise imaging of the healing process that gives an insight of the fate of CIHs.DiscussionThis case raises awareness of CIH as differential diagnosis for myocardial ischaemia during aortic root surgery. It underlines the effectiveness of immediate surgical revascularization, highlights the potential temporary role of coronary artery bypass graft that can stabilize the acute coronary syndrome and may give time to the CIH to reabsorb and native coronary circulation to re-establish.

| S-EPMC7780453 | biostudies-literature

Comparison of drug-coated balloon angioplasty versus common balloon angioplasty for arteriovenous fistula stenosis: A systematic review and meta-analysis.

Project description:Drug-coated balloons (DCBs) have been used in dialysis patients with arteriovenous fistula (AVF) stenosis, but whether DCBs have advantages over ordinary balloons is still controversial. A meta-analysis was designed to investigate the safety and efficacy of DCBs and common balloons (CBs) in the treatment of AVF stenosis. We searched the PubMed, EMBASE, and China National Knowledge Internet (CNKI) databases for randomized controlled trials that evaluated the comparison of DCB angioplasty versus CB angioplasty for AVF stenosis in dialysis patients and reported at least one outcome of interest. The results showed that the DCB group had a higher first-stage patency rate of the target lesion 6 months [odds ratio, OR = 2.31, 95% confidence interval, CI: (1.69, 3.15), p < .01] and 12 months [OR = 2.09, 95% CI: (1.50, 2.91), p < .01] after surgery. There was no statistically significant difference in all-cause mortality between the two groups at 6 months [OR = 0.85, 95% CI: (0.47, 1.52), p = .58] and 12 months [OR = 0.99, 95% CI: (0.60, 1.64), p = .97]. Compared with CB, DCBs as a new endovascular treatment for AVF stenosis have a higher primary patency rate of target lesions and can delay the occurrence of restenosis. There is no evidence that DCB can increase the mortality of patients.

| S-EPMC10436783 | biostudies-literature

Rare complication of subacute renal artery intramural haematoma after renal artery stenting: a case report.

Project description:Renal artery intramural haematoma (IMH) is a rare cause of renal artery obstruction after stenting. Diagnosis and treatment are difficult as there are only a few cases reported. We present the case of sudden-onset abdominal pain and non-functional kidney 3 days after renal artery stent implantation. Subacute luminal narrowing of the renal artery was initially diagnosed using computed tomography angiography and renal artery angiography, and a final diagnosis of subacute renal artery IMH was made using intravascular ultrasound (IVUS). Subsequently, the patient was treated with percutaneous transluminal angioplasty from far to near and another stent implantation. At the third month follow-up, blood pressure and renal function were normal. This case suggests that IVUS could be useful for qualifying and treating the subacute renal artery IMH.

| S-EPMC6601150 | biostudies-literature

Emergency pericardial drainage without aortic repair for type A intramural haematoma complicated by cardiac tamponade.

Project description:From April 2011 to March 2020, 87 patients with type A intramural haematoma and acute aortic dissection with thrombosed false lumen of the ascending aorta were treated at Kitasato University Hospital. The initial watch-and-wait strategy without emergency aortic repair was taken in 52 cases in which the maximum aortic diameter was ≤50 mm, pain score on arrival at our hospital was ≤3/10 on the numerical rating scale and there was no ulcer-like projection (ULP) in the ascending aorta. Eleven patients who fulfilled the criteria but developed cardiac tamponade underwent emergency pericardial drainage without aortic repair. Among these 11 patients, 3 patients developed an aortic event during the hospitalization; 1 patient developed enlargement of the ULP 18 days later but refused surgery, another patient developed rupture of the dissected brachiocephalic artery 4 days later and underwent emergency repair of the ascending aorta and the brachiocephalic artery and the other patient developed a new ULP in the ascending aorta 14 days later and underwent aortic repair. All 11 patients were discharged home. During follow-up (3.0 ± 2.4 years), 1 patient developed a recurrent type A acute aortic dissection and underwent emergency aortic repair 29 months later. There was no aorta-related death.

| S-EPMC8759486 | biostudies-literature

Verification of Optimal Balloon Size in Balloon Pulmonary Angioplasty for Chronic Thromboembolic Pulmonary Hypertension.

Project description: Not available

| S-EPMC10322746 | biostudies-literature