Managing Stenotic Septal Perforator Branches

Saidi, Abdulfattah; Tandar, Anwar; Welt, Frederick G.P.; Owan, Theophilus

doi:10.14503/thij-16-6030

Cited by 5 publications

(5 citation statements)

References 11 publications

(17 reference statements)

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“…Although infrequently performed, PCI for SPB has been shown to be feasible in selected patients. 16) In our case, angioplasty for the lethal "jailed" SPB helped to successfully resolve the acute conduction disturbances. Most of the eight published cases demonstrated the following various conduction abnormalities at baseline: first-degree AV block, left bundle branch block, CRBBB, and LAFB.…”

Section: Discussionmentioning

confidence: 62%

Rescue Percutaneous Coronary Intervention for a Lethal "Jailed" Septal Perforator Branch to Resolve Delayed Complete Atrioventricular Block

et al. 2019

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Delayed complete atrioventricular (AV) block associated with an occluded septal perforator branch (SPB) is an uncommon complication after performing percutaneous coronary intervention (PCI) for the left anterior descending coronary artery (LAD). Here we report the case of a 74-year-old man who underwent elective PCI for proximal LAD complicated with occlusion of the first major SPB and developed a complete AV block 78 hours after PCI was performed. The patient received a temporary transvenous pacemaker via the jugular vein and successfully underwent balloon angioplasty of the lethal "jailed" SPB, resulting in recovery from the complete AV block. Permanent pacemaker implantation was avoided. Our findings indicate the importance of postprocedural monitoring and consideration of rescue PCI for an occluded SPB in cases of complicated AV conduction disturbances.(Int Heart J 2019; 60: 457-461)

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Section: Discussionmentioning

confidence: 62%

Rescue Percutaneous Coronary Intervention for a Lethal "Jailed" Septal Perforator Branch to Resolve Delayed Complete Atrioventricular Block

et al. 2019

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“…Without justified invasive intervention, a medical management-only approach can be considered. This approach has been described in an asymptomatic 39-year-old male who presented with NSTEMI, 5800 ng/L troponin I level, and no discernable ischemic EKG changes [9]. CA suggested the culprit lesion involving occlusion of the first SPB.…”

Section: Discussionmentioning

confidence: 96%

Feasible stenting of a large septal perforator providing a sizeable coronary collaterals

Hennawi

Mathbout

Taftafa

et al. 2022

gcsp

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While coronary artery disease involving the septal perforator branches presents similar to diseases of major coronary arteries, management can present a challenge. Owing to their relatively small size, performing interventional procedures is often impractical in terms of selecting appropriate devices. Although larger septal perforator branches have been managed percutaneously, similar to major vessels, long-term sequelae and clinical effectiveness have been indeterminate. We present our experience in managing a patient with a stenosed septal perforator branch and challenging comorbidities.

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“…However, for the same reason, vessels of class S are invasively treated only in exceptional cases and usually play a subordinate role in the perfusion of the heart. 34 Hence, these errors are of limited clinical relevance. Moreover, the retrospective analysis revealed that the moderate performance for the LM segments may have been associated with tracking beyond the ostium into the aorta, causing the ensemble for tree refinement to discard the entire branch in some cases.…”

Section: Discussionmentioning

confidence: 99%

“…These branches are typically short and thin and hence also challenging to identify visually. However, for the same reason, vessels of class S are invasively treated only in exceptional cases and usually play a subordinate role in the perfusion of the heart 34 . Hence, these errors are of limited clinical relevance.…”

Section: Discussionmentioning

confidence: 99%

Graph neural networks for automatic extraction and labeling of the coronary artery tree in CT angiography

Hampe,

van Velzen,

Wolterink

et al. 2024

J. Med. Imag.

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Automatic comprehensive reporting of coronary artery disease (CAD) requires anatomical localization of the coronary artery pathologies. To address this, we propose a fully automatic method for extraction and anatomical labeling of the coronary artery tree using deep learning.Approach: We include coronary CT angiography (CCTA) scans of 104 patients from two hospitals. Reference annotations of coronary artery tree centerlines and labels of coronary artery segments were assigned to 10 segment classes following the American Heart Association guidelines. Our automatic method first extracts the coronary artery tree from CCTA, automatically placing a large number of seed points and simultaneous tracking of vessel-like structures from these points. Thereafter, the extracted tree is refined to retain coronary arteries only, which are subsequently labeled with a multi-resolution ensemble of graph convolutional neural networks that combine geometrical and image intensity information from adjacent segments. Results:The method is evaluated on its ability to extract the coronary tree and to label its segments, by comparing the automatically derived and the reference labels. A separate assessment of tree extraction yielded an F 1 score of 0.85. Evaluation of our combined method leads to an average F 1 score of 0.74. Conclusions:The results demonstrate that our method enables fully automatic extraction and anatomical labeling of coronary artery trees from CCTA scans. Therefore, it has the potential to facilitate detailed automatic reporting of CAD.

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Managing Stenotic Septal Perforator Branches

Cited by 5 publications

References 11 publications

Rescue Percutaneous Coronary Intervention for a Lethal "Jailed" Septal Perforator Branch to Resolve Delayed Complete Atrioventricular Block

Rescue Percutaneous Coronary Intervention for a Lethal "Jailed" Septal Perforator Branch to Resolve Delayed Complete Atrioventricular Block

Feasible stenting of a large septal perforator providing a sizeable coronary collaterals

Graph neural networks for automatic extraction and labeling of the coronary artery tree in CT angiography

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