successful isolation of a huge saccular coronary aneurysm ...3).pdflca, rao cau, rca, cto,...
TRANSCRIPT
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Successful Isolation of a Huge Saccular Coronary Aneurysm by Combined Coil Embolization and Drug Eluting Stenting
Presenter; Eun Jin Park Operator; Seung Woon Rha
Cardiovascular Center
Korea University Guro Hospital
1st
complex PCI 2016
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Patient’s Information
F/56
Chief complaint Referred for Lt. iliac a. stenting
Past Histroy HTN/DM/Hep/Tb/CKD (+/-/-/-/-)
Kawasaki Dz (-)
Lt carorid stenting (4MA)
A/S (-/-)
Familiy Hx (-/-)
Laboratory findings Routine lab & Cardiac enzyme; WNL
hsCRP, ESR; WNL
FANA/ANA (-/-), C3/C4 (-/-)
No evidence of systemic inflammation nor vasculitis
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Baseline Coronary Angiogram
LCA, RAO cau, RCA, CTO, collateral from LCX (Gr.3)
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EKG
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Echocardiography
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Seal the Rim of the CAA
Micro catheter tip (Finecross ,Terumo, Japan)
* Retrievable coil Interlock 3X12mm (Boston scientific, USA)
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Packing remnant space of the CAA
Micro catheter tip
* Non-retrievable - coil Tornado 3X2mm (Cook, USA)
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Wiring
Sion black (Asahi, Japan)
Finecross microcatheter (Terumo, Japan) Grandslam (Asahi, Japan)
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DES positioniong at inlet of Aneurysm
Orsiro 3.0x18mm (Biotronik, Germany) Parallel wiring and stent delivery through soft wire
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Final Angiogram
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Coil embolization of CAA
Circ Cardiovasc Interv 2012;5:e3-e
Catheterization and Cardiovascular Interventions 79:1000–1003 (2012)
* Micro catheter entrapping with stent deploying
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Conclusion
Huge saccular coronary aneurysm companied by severe stenosis
1. Seal the rim of the aneurysm
with Retrievable coil
2. Packing the remnant space
with non-retrievable coil
3. Wiring to the distal vessel
beside the aneurysm
4. DES implantation along with
soft wire following parallel
wiring