Browse
Submit Data
Databases
API
Help

Dataset Information

23 Views

0 Connections

0 Citations

0 Reanalyses

0 Downloads

Omics score: 0

Successful Coronary Flow Restoration by Stent-Free Strategy Using the Pull-Back Method of Cutting Balloon in Spontaneous Coronary Artery Dissection.

ABSTRACT: This report describes a 46-year-old woman with ST-elevation myocardial infarction due to spontaneous coronary artery dissection. Because continuous chest pain and ST-segment elevation in electrocardiography indicated ongoing cardiac ischemia, the urgent revascularization strategy was used using a novel method of cutting balloon angioplasty, "the pull-back of inflated cutting balloon," which led to the successful coronary flow restoration and complete healing of dissected coronary artery in 1 year. The pull-back of the inflated cutting balloon method is a useful therapeutic option in the treatment of patients with spontaneous coronary artery dissection with ongoing cardiac ischemia.

SUBMITTER: Kaya E

PROVIDER: S-EPMC7063649 | biostudies-literature | 2019 Jul

REPOSITORIES: biostudies-literature

ACCESS DATA

Json Xml

Publications

Successful Coronary Flow Restoration by Stent-Free Strategy Using the Pull-Back Method of Cutting Balloon in Spontaneous Coronary Artery Dissection.

Kaya Esra E Iwata Hiroshi H Miyazaki Sakiko S Mattson Peter C PC Takamura Kazuhisa K Nishiyama Hiroki H Okai Iwao I Okazaki Shinya S Daida Hiroyuki H

CJC open 20190530 4

This report describes a 46-year-old woman with ST-elevation myocardial infarction due to spontaneous coronary artery dissection. Because continuous chest pain and ST-segment elevation in electrocardiography indicated ongoing cardiac ischemia, the urgent revascularization strategy was used using a novel method of cutting balloon angioplasty, "the pull-back of inflated cutting balloon," which led to the successful coronary flow restoration and complete healing of dissected coronary artery in 1 yea ...[more]

PMID: 32159110

Similar Datasets

Successful percutaneous treatment of occlusive spontaneous coronary artery dissection with a 'pull-back injection technique': case report.

Project description:BackgroundSpontaneous coronary artery dissection (SCAD) is a rare condition that can cause acute coronary syndrome, typically in young patients without classical cardiovascular risk factors. Although in SCAD the conservative management is preferable, in cases with complete occlusion of the artery an invasive treatment may be required. In such cases, the goal of the percutaneous intervention should be to restore the connection between the true and false lumen recovering the distal flow of the vessel.Case summaryA young man was admitted with acute chest pain and ST segment elevation in precordial v3-v6 leads. An emergent coronary angiogram showed an abrupt occlusion of middle left anterior descending artery compatible with SCAD. A microcatheter was advanced distally into the artery and pulled back with continuous contrast injection through the catheter, restoring the distal flow with a residual spiroid intimal flap and with relief of the chest discomfort. A computed tomography performed during admission showed complete resolution of the lesion.DiscussionIn SCAD with complete occlusion of the vessel, the 'pull-back technique' with continuous vigorous injection of contrast through a distal microcatheter may be effective to restore the distal flow enabling the healing of the artery at follow-up and avoiding the stent implant.

| S-EPMC8274651 | biostudies-literature

Successful treatment of a spontaneous right coronary artery dissection with a 4-mm diameter cutting balloon: a case report.

Project description:Background:Guidelines recommend conservative management for a spontaneous coronary artery dissection (SCAD) in the absence of ongoing ischaemia, haemodynamic instability, or left main dissection. Conventional percutaneous coronary intervention methods for SCAD are associated with an unfavourable prognosis due to difficulties wiring the lesion, dissection propagation, and potential 'milking' of the intramural haematoma along the vessel or into other vessels. These factors promote implantation of multiple stents which are often undersized, increasing the risk of in-stent restenosis significantly. There have been several case reports demonstrating the novel use of small diameter cutting balloons in the left anterior descending artery system. Here, we describe the successful use of a larger 4?mm cutting balloon to treat a spontaneous right coronary artery (RCA) dissection. Case summary:A 53-year-old woman with troponin negative chest pain and was diagnosed with unstable angina due to ischaemic electrocardiographic features. Coronary angiography revealed a tight discrete lesion in the RCA. Intravascular imaging confirmed SCAD and a 4?mm cutting balloon was used to dissect the tunica intima to allow complete resorption of the intramural haematoma and resolution of symptoms. Discussion:This case demonstrates the safe use of a larger 4?mm cutting balloon to treat an RCA SCAD, resulting in complete resolution of the haematoma.

| S-EPMC6939819 | biostudies-literature

An analysis of published cases of cutting balloon use in spontaneous coronary artery dissection.

Project description:IntroductionSCAD involves a sudden tear or separation within the layers of the coronary artery wall, resulting in blood flow obstruction and subsequent myocardial ischemia.Materials and methodsA comprehensive literature search was conducted to identify relevant published cases of cutting balloon use in patients diagnosed with spontaneous coronary artery dissection. Electronic databases including PubMed, MEDLINE, Embase, Cochrane Library and Google Scholar were systematically searched from inception until the present using terms "cutting balloon," "SCAD," "acute coronary syndrome," "intramural hematoma," and "angioplasty."ResultsA total of 32 published cases of cutting balloon use in spontaneous coronary artery dissection were analyzed in this study. The majority of the patients included in the analysis were female without prior history of cardiovascular disease. The median age of the SCAD population was approximately 46 years. The most frequently affected artery in SCAD cases was the Left Anterior Descending artery. Intravascular ultrasound was utilized more frequently than other modalities of adjunctive imaging techniques. The most frequent complication was the distal propagation of hematoma. Despite the successful dilation achieved with the cutting balloon, in some cases stenting was required to provide additional support.ConclusionThe results of this analysis demonstrate that cutting balloon use in SCAD cases yields favorable outcomes.

| S-EPMC10666782 | biostudies-literature

Intimal flap sealing and healing with perfusion balloon in spontaneous coronary artery dissection.

Project description: Not available

| S-EPMC10015474 | biostudies-literature

Unusual interventional treatment of spontaneous coronary artery dissection without stent implantation: a case series.

Project description:BackgroundSpontaneous coronary artery dissection (SCAD) is a unique cause of myocardial infarction, and optimal treatment should be selected according to the ischaemic condition. Patients with ongoing ischaemia or haemodynamic instability may require revascularization. Cutting balloon (CB) angioplasty has been acknowledged as an option for revascularization. However, few observations of the coronary artery conditions after CB angioplasty in SCAD patients have been reported. Here, we demonstrate two cases in which we evaluated the angiographic morphology of targeted coronary arteries in the chronic phase after CB angioplasty.Case summaryPatient 1 was a 46-year-old woman who presented at our hospital with chest pain. Electrocardiography suggested acute coronary syndrome and coronary angiography was performed. The coronary angiography and intravascular ultrasound (IVUS) examinations revealed SCAD in the left anterior descending artery (LAD). Revascularization with CB angioplasty was successful. Follow-up coronary angiography 15 months after the angioplasty showed no visible stenosis in the LAD. Accordingly, the patient no longer needed to antiplatelet therapy. Patient 2 was a 50-year-old woman who was transported to our hospital for ventricular tachycardia. Coronary angiography and IVUS revealed SCAD in the right coronary artery. Coronary flow was restored by CB angioplasty. Follow-up contrast-enhanced computed tomography angiography 36 months after angioplasty showed a healed appearance. Thus, she was able to discontinue antiplatelet therapy.DiscussionCutting balloon angioplasty may be a possible method to treat SCAD.

| S-EPMC8350351 | biostudies-literature

Coronary artery dissection by an oversized balloon.

Project description:Percutaneous coronary intervention (PCI) as a treatment of coronary artery disease can be a simple, rapid procedure with a clear benefit for the patient, but it could also become a complex procedure with fatal consequences. These complications depend on the lesion itself, material used and also on operating staff. In this case we report a coronary artery dissection of the circumflex (CX) artery caused by inflation of an oversized balloon. We discuss here the management and evolution of this complication.

| S-EPMC4256603 | biostudies-literature

Progression of left anterior descending artery dissection due to stent implantation for spontaneous coronary artery dissection of left circumflex artery: a case report.

Project description:Background:Spontaneous coronary artery dissection (SCAD) is a rare disease that predominantly affects woman. Percutaneous coronary intervention (PCI) is recommended only in patients with ongoing ischaemia because it carries a high risk of procedural complications in SCAD patients. Case summary:A 51-year-old woman was admitted to our institution owing to severe chest pain. Coronary angiography showed a diffuse narrowing and radiolucent luminal flap which runs parallel to the vessel wall in the proximal left circumflex coronary artery and SCAD was diagnosed. After PCI was undertaken, optical coherence tomography disclosed a circular haematoma at the stent distal segment and an intimal tear at the distal left main coronary artery. A conservative approach was decided owing to patient stability without evidence of ongoing ischaemia and normal coronary flow. Thirty minutes later, the patient started to complain of chest pain with the ST-segment elevation in leads I, aVL, and V2-3. Coronary angiography demonstrated a total occlusion of the second diagonal brunch and double lumen morphology at the proximal-potion of left anterior descending with TIMI2 distal flow suggesting the extension of coronary dissection. Optical coherence tomography imaging revealed that the entry door of the dissection was located where the small intimal tear was found. Percutaneous coronary intervention was successfully performed, and the patient was discharged without any complication. Discussion:Although the underlying mechanism of recurrent SCAD remain largely unknown, our case suggests that the residual inlet of the dissection may associate with the extension of the coronary dissection.

| S-EPMC6939789 | biostudies-literature

Spontaneous multivessel coronary artery dissection with anomalous coronary artery.

Project description:Spontaneous coronary artery dissection (SCAD) is one of the rare causes of acute coronary syndrome in young healthy individuals especially women without having any conventional risk factors for coronary artery disease. We describe a case of 34-year-old healthy man with diffuse multiple SCADs who presented with acute coronary syndrome and was managed conservatively with an uneventful course on long-term follow-up.

| S-EPMC3644896 | biostudies-other

Successful transcatheter stent retrieval after stent dislodgement in the left main coronary artery.

Project description: Not available

| S-EPMC10422688 | biostudies-literature

Spontaneous Coronary Artery Dissection: Less Is More!

Project description:Spontaneous coronary artery dissection (SCAD) is a rare cause of acute myocardial infarction (ACS). We report a case of acute coronary syndrome due to SCAD of the right coronary artery. Diagnosis was based on clinical presentation and coronary angiography, and confirmed by optical coherence tomography which guided our treatment strategy. (Level of Difficulty: Beginner.).

| S-EPMC8305066 | biostudies-literature

OmicsDI is part of the ELIXIR infrastructure

OmicsDI is an Elixir interoperability service. Learn more ›

Tweets

OmicsDI Databases

PRIDE
PeptideAtlas
MassIVE
JPOST Repository
Physiome Model Repository

EGA
EVA
ENA
LINCS
PAXDB
Cell Collective

MetaboLights
Metabolomics Workbench
MetabolomeExpress
GNPS
BioModels
FAIRDOMHub

ArrayExpress
dbGaP
ExpressionAtlas
GEO
NODE

Information

Databases
Help
API
Contact us
Code on GitHub
Terms of use
Submit Data