A case achieved successful revascularization to severe ischemic coronary artery disease after endovascular recanalization with infrarenal aortic occlusion

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• 作者：Yasunari Sakamoto (1)
  Toshiya Muramatsu (1)
  Reiko Tsukahara (1)
  Yoshiaki Ito (1)
  Hiroshi Ishimori (1)
  Keisuke Hirano (1)
  Masatsugu Nakano (1)
  
• 关键词：Acute coronary syndrome ; Endovascular therapy ; Percutaneous coronary intervention ; Aorto iliac occlusive disease
• 刊名：Cardiovascular Intervention and Therapeutics
• 出版年：2012
• 出版时间：May 2012
• 年：2012
• 卷：27
• 期：2
• 页码：93-98
• 全文大小：556KB
• 参考文献：1. Lloyd-Jones D, Adams RJ, Brown TM, Carnethon M, Dai S, De Simone G, et al. Heart disease and stroke statistics-2010 update. A report from the American Heart Association. Circulation. 2010;121:e46-15. CrossRef
  2. Norgren L, Hiatt WR, Dormandy JA, Nehler MR, Harris KA, Fowkes FG, et al. Inter-Society Consensus for the management of peripheral arterial disease (TASC II). J Vasc Surg. 2007;45 Suppl S:S5-7. CrossRef
  3. Poulias GE, Doundoulakis N, Prombonas E, Haddad H, Papaioannou K, Lymberiades D, et al. Aorto-femoral bypass and determinants of early success or late favorable outcome. Experience with 1000 consecutive cases. J Cardiovasc Surg (Torino). 1992;33:664-8.
  4. Hans SS, DeSantis D, Siddiqui R, Khoury M. Result of endovascular therapy and aortobifemoral grafting for Transatlantic Inter-Society type C and D aortoiliac occlusive disease. Surgery. 2008;144:583-. CrossRef
  5. Burke CR, Henke PK, Hernandez R, Rectenwald JE, Krishnamurthy V, Englesbe MJ, et al. A contemporary comparison of aortofemoral bypass and aortoiliac stenting in the treatment of aortoiliac occlusive disease. Ann Vasc Surg. 2010;24:4-3. CrossRef
  6. Hirsch AT, Haskal ZJ, Hertzer NR, Bakal CW, Creager MA, Halperin JL, et al. ACC/AHA 2005 guidelines for the management of patients with peripheral arterial disease (lower extremity, renal, mesenteric, and abdominal aortic): executive summary a collaborative report from the American Association for Vascular Surgery/Society for Vascular Surgery, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, Society of Interventional Radiology, and the ACC/AHA Task Force on Practice Guidelines (Writing Committee to Develop Guidelines for the Management of Patients With Peripheral Arterial Disease). J Am Coll Cardiol. 2006;47:1239-12. CrossRef
  7. Noel BM, Glenton O, Barbeau GR, et al. Transbrachial insertion of an intra-aortic balloon pump for complex coronary angioplasty. Catheter Cardiovasc Interv. 2003;60:36-. CrossRef
  8. Laganà D, Carrafiello G, Mangini M, Lumia D, Caronno R, Castelli P, et al. Endovascular treatment of steno-occlusions of the infrarenal abdominal aorta. Radiol Med. 2006;111:949-8. CrossRef
  9. Moise MA, Alvarez-Tostado JA, Clair DG, Greenberg RK, Lyden SP, Srivastava SD, et al. Endovascular management of chronic infrarenal aortic occlusion. J Endovasc Ther. 2009;16:84-2. CrossRef
  10. Shin ES, Garcia–Garcia HM, Okamura T, Wykrzykowska JJ, Gonzalo N, Shen ZJ, et al. Comparison of acute vessel wall injury after self-expanding stent and conventional balloon-expandable stent implantation: a study with optical coherence tomography. J Invasive Cardiol. 2010;22:435-.
  11. Serruys PW, Morice MC, Kappetein AP, Colombo A, Holmes DR, Mack MJ, et al. Percutaneous coronary intervention versus coronary-artery bypass grafting for severe coronary artery disease. N Engl J Med. 2009;360:961-2. CrossRef
  12. Nashef SA, Roques F, Michel P, Gauducheau E, Lemeshow S, Salamon R. European system for cardiac operative risk evaluation (EuroSCORE). Eur J Cardiothorac Surg. 1999;16:9-3. CrossRef
  
• 作者单位：Yasunari Sakamoto (1)
  Toshiya Muramatsu (1)
  Reiko Tsukahara (1)
  Yoshiaki Ito (1)
  Hiroshi Ishimori (1)
  Keisuke Hirano (1)
  Masatsugu Nakano (1)
  
  1. Division of Cardiology, Saiseikai Yokohama City Eastern Hospital, 3-6-1 Shimosueyoshi, Tsurumi-ku, Yokohama, Kanagawa, 230-0012, Japan
  

文摘

An 80-year-old woman was admitted to our emergency department with ongoing dyspnea for 2?weeks. The patient was immediately intubated endotracheally because of the hypoxia with flush pulmonary edema. Electrocardiogram showed ST depression and echocardiogram showed hypokinesis of anterior left ventricular wall with poor systolic function. Also her cardiac enzymes were elevated, emergency coronary angiogram was performed from radial artery because both femoral arteries were not fully palpable. Coronary angiogram showed three vessels disease including chronic total occlusion of right coronary artery and left main bifurcation lesion. Also blood flow of left anterior descending coronary artery was delayed. Acute coronary syndrome was the cause of acute heart failure and revascularization was needed but aortography revealed total occlusion of infrarenal aorta. Patient was relatively hemodynamically stable; we planned treating total occlusion of infrarenal aorta with endovascular therapy to maintain a rout for cardiopulmonary support system. With bi-directional approach from both femoral artery and left brachial artery, occlusion site with heavy calcification was finally passed through by guide wire from retrograde approach. After pull-through technique, self-expanding nitinol stent was implanted after pre dilation with small balloon. Considering her EURO score, supposed perioperative mortality was high, percutaneous coronary intervention was performed. A 7?fr sheath was inserted from right femoral artery and intra-aortic balloon pump was inserted from left femoral artery. Sirolimus-eluting stent was implanted to left circumflex artery and also from ostium of left main to mid left anterior descending coronary artery after using an atherectomy device. After successful revascularization, patient became hemodynamically stable and weaning off the respirator was successful. Reporting case achieved successful revascularization to severe coronary artery disease after endovascular recanalization with infrarenal aortic occlusion.