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Covered stents in giant coronary artery aneurysm

Covered stents in giant coronary artery aneurysm Cardiovascular flashlight 2823 doi:10.1093/eurheartj/ehq267 CARDIOVASCULAR FLASHLIGHT Online publish-ahead-of-print 30 July 2010 ............................................................................................................................................................................. 1 2 1 Sabrina Siregar *, Siyrous Hoseyni Guyomi , and Lex A. van Herwerden Division Heart and Lungs, Department of Cardio-Thoracic Surgery, University Medical Center Utrecht, Heidelberglaan 100, E03.511, PO Box 85500, 3508GA Utrecht, The Netherlands; and Division Heart and Lungs, Department of Interventional Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands * Corresponding author. Tel: +31 88 7556179, Fax: +31 88 7555058, Email: sabrina.siregar@gmail.com A 71-year-old woman presented with stable angina pectoris. On cor- onary angiography, a giant aneurysm of the left anterior descending artery (LAD) measuring 70 × 40 mm was seen. The aneurysm was lined with thrombus (Panel A: aneur- ysm indicated by large arrows and lumen indicated by small arrows; see Supplementary material online, Video S1). Proximal and distal to the aneurysm, the LAD was severely ste- nosed, with limited flow in its apical part. The aneurysm was excluded using pericardium-covered stents. After balloon dilatation, proximal and distal bare-metal stents were used as an anchor for three intercon- nected equine pericardium-covered stents. This resulted in restoration of flow in the distal LAD. After 3 months of follow-up, the patient was symptom free. Coronary angiography (Panel B; see Supplemen- tary material online, Video S2), com- puted tomography (CT) angiography (Panel C), and the three-dimensional CT reconstruction (Panel D) showed exclusion of the aneurysm and unobstructed flow through the stents (Panels B–D: aneurysm indicated by large arrows and stents indicated by small arrows). Supplementary material is available at European Heart Journal online. Panel A. Coronary angiography showing giant coronary artery aneurysm in the left anterior descending artery. The aneurysm is indi- cated by large arrows and the lumen is indicated by small arrows. Panel B. Coronary angiography showing exclusion of the coronary artery aneurysm and restoration of flow in the distal left anterior descending artery 3 months after placement of pericardium-covered stents. The aneurysm is indicated by large arrows and the stents are indicated by small arrows. Panel C. Computed tomography angiography 3 months after intervention. The aneurysm is indicated by large arrows and the stents are indicated by small arrows. Panel D. Three-dimensional computed tomography reconstruction 3 months after intervention, showing the aneurysm as well as the covered stents. The aneurysm is indicated by green arrows and the stents are indicated by the red arrow. Published on behalf of the European Society of Cardiology. All rights reserved. & The Author 2010. For permissions please email: journals.permissions@oxfordjournals.org. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png European Heart Journal Oxford University Press

Covered stents in giant coronary artery aneurysm

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Publisher
Oxford University Press
Copyright
Published on behalf of the European Society of Cardiology. All rights reserved. The Author 2010. For permissions please email: journals.permissionsoxfordjournals.org
Subject
CARDIOVASCULAR FLASHLIGHTS
ISSN
0195-668X
eISSN
1522-9645
DOI
10.1093/eurheartj/ehq267
pmid
20675659
Publisher site
See Article on Publisher Site

Abstract

Cardiovascular flashlight 2823 doi:10.1093/eurheartj/ehq267 CARDIOVASCULAR FLASHLIGHT Online publish-ahead-of-print 30 July 2010 ............................................................................................................................................................................. 1 2 1 Sabrina Siregar *, Siyrous Hoseyni Guyomi , and Lex A. van Herwerden Division Heart and Lungs, Department of Cardio-Thoracic Surgery, University Medical Center Utrecht, Heidelberglaan 100, E03.511, PO Box 85500, 3508GA Utrecht, The Netherlands; and Division Heart and Lungs, Department of Interventional Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands * Corresponding author. Tel: +31 88 7556179, Fax: +31 88 7555058, Email: sabrina.siregar@gmail.com A 71-year-old woman presented with stable angina pectoris. On cor- onary angiography, a giant aneurysm of the left anterior descending artery (LAD) measuring 70 × 40 mm was seen. The aneurysm was lined with thrombus (Panel A: aneur- ysm indicated by large arrows and lumen indicated by small arrows; see Supplementary material online, Video S1). Proximal and distal to the aneurysm, the LAD was severely ste- nosed, with limited flow in its apical part. The aneurysm was excluded using pericardium-covered stents. After balloon dilatation, proximal and distal bare-metal stents were used as an anchor for three intercon- nected equine pericardium-covered stents. This resulted in restoration of flow in the distal LAD. After 3 months of follow-up, the patient was symptom free. Coronary angiography (Panel B; see Supplemen- tary material online, Video S2), com- puted tomography (CT) angiography (Panel C), and the three-dimensional CT reconstruction (Panel D) showed exclusion of the aneurysm and unobstructed flow through the stents (Panels B–D: aneurysm indicated by large arrows and stents indicated by small arrows). Supplementary material is available at European Heart Journal online. Panel A. Coronary angiography showing giant coronary artery aneurysm in the left anterior descending artery. The aneurysm is indi- cated by large arrows and the lumen is indicated by small arrows. Panel B. Coronary angiography showing exclusion of the coronary artery aneurysm and restoration of flow in the distal left anterior descending artery 3 months after placement of pericardium-covered stents. The aneurysm is indicated by large arrows and the stents are indicated by small arrows. Panel C. Computed tomography angiography 3 months after intervention. The aneurysm is indicated by large arrows and the stents are indicated by small arrows. Panel D. Three-dimensional computed tomography reconstruction 3 months after intervention, showing the aneurysm as well as the covered stents. The aneurysm is indicated by green arrows and the stents are indicated by the red arrow. Published on behalf of the European Society of Cardiology. All rights reserved. & The Author 2010. For permissions please email: journals.permissions@oxfordjournals.org.

Journal

European Heart Journal – Oxford University Press

Published: Nov 30, 2010

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