Catastrophic catheter-induced coronary artery vasospasm successfully rescued using intravascular ultrasound imaging guidance

Kodaira, Masaki; Tabei, Ryota; Kuno, Toshiki; Numasawa, Yohei

doi:10.1136/bcr-2017-222607

Cited by 3 publications

(2 citation statements)

References 28 publications

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“…Coronary artery spasm is one of the etiopathogenetic mechanisms of acute coronary syndromes in patients with no other pathology in coronary arteries [7][8][9]. Patient may even undergo coronary artery bypass surgery due to a misdiagnosis in which coronary artery spasm was misinterpreted as fixed atherosclerotic obstruction [10].…”

Section: Discussionmentioning

confidence: 99%

Catheter-induced Multiple Non-proximal Coronary Spasm in a Patient Presenting with Myocardial Infarction

Esenboğa

Baskovski

Özyüncü

et al. 2020

Cureus

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Interventional cardiologists encounter a wide range of lesions that cannot be angiographically distinguished from fixed atherosclerotic obstructive disease. In this case report, we document vasospasm at multiple sites in the coronary territory in a patient presenting with acute coronary syndrome. A 61-year-old woman was referred to our hospital with typical chest pain lasting approximately 1 h. After performing the left coronary artery angiography, a severe tubular stenosis was detected in circumflex (Cx) artery. Diffuse spasm was observed in the right coronary artery (RCA) and it resolved after intracoronary administration of nitroglycerin. After performing left system angiography again, severe stenosis in Cx artery was also completely resolved. Our finding is of clinical importance in that it is more likely to simulate a constant coronary stenosis than would have spasm occurred proximally. The clinical importance of our report is that a catheter-induced vasospasm (CIV) may simulate fixed coronary stenosis, not always osteally and in some instances at multiple sites. Awareness of this phenomenon and liberal use of nitroglycerin in any patient with discrete luminal narrowing, even when an ostial "lesion" is not present, can help to avoid misinterpreting CIV as an atherosclerotic lesion.

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Section: Discussionmentioning

confidence: 99%

Catheter-induced Multiple Non-proximal Coronary Spasm in a Patient Presenting with Myocardial Infarction

Esenboğa

Baskovski

Özyüncü

et al. 2020

Cureus

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“…Indeed, its diagnostic ability was confirmed, as ICA revealed LMCA stenosis of more than 50% in only 2.9% patients without LMCA disease, according to CCTA [ 40 ]. In addition, CCTA could be used in patients with anomalous LMCA origin, in patients suffering from catheter-induced vasospasm, and in those having undergone coronary artery bypass surgery [ 41 , 42 , 43 ]. Last, CCTA has been proven as an acceptable solution for the detection of in-stent stenosis in LMCA.…”

Section: Imaging Modalities For Lmca Disease Depictionmentioning

confidence: 99%

Imaging of Left Main Coronary Artery; Untangling the Gordian Knot

Toutouzas¹,

Gerakaris²,

Tsoni³

et al. 2023

Rev. Cardiovasc. Med.

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Left Main Coronary Artery (LMCA) disease is considered a standout manifestation of coronary artery disease (CAD), because it is accompanied by the highest mortality. Increased mortality is expected, because LMCA is responsible for supplying up to 80% of total blood flow to the left ventricle in a right-dominant coronary system. Due to the significant progress of biomedical technology, the modern drug-eluting stents have remarkably improved the prognosis of patients with LMCA disease treated invasively. In fact, numerous randomized trials provided similar results in one-and five-year survival of patients treated with percutaneous coronary interventions (PCI) -guided with optimal imaging and coronary artery bypass surgery (CABG). However, interventional treatment requires optimal imaging of the LMCA disease, such as intravascular ultrasound (IVUS) and optical coherence tomography (OCT). The aim of this manuscript is to review the main pathophysiological characteristics, to present the imaging techniques of LMCA, and, last, to discuss the future directions in the depiction of LMCA disease.

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Intravascular Ultrasound Diagnosis of Severe Left Main Coronary Artery Spasm: A Case Report and Literature Review

黄¹

2022

ACM

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Catastrophic catheter-induced coronary artery vasospasm successfully rescued using intravascular ultrasound imaging guidance

Cited by 3 publications

References 28 publications

Catheter-induced Multiple Non-proximal Coronary Spasm in a Patient Presenting with Myocardial Infarction

Catheter-induced Multiple Non-proximal Coronary Spasm in a Patient Presenting with Myocardial Infarction

Imaging of Left Main Coronary Artery; Untangling the Gordian Knot

Intravascular Ultrasound Diagnosis of Severe Left Main Coronary Artery Spasm: A Case Report and Literature Review

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