Novel technique for coil embolization of intercostal branch of internal mammary artery graft

Patel, Vipool; Bailey, Steven R.; O’Leary, Edward; Hoyer, Mark V.

doi:10.1002/(sici)1097-0304(199710)42:2<229::aid-ccd32>3.0.co;2-g

Cited by 8 publications

(8 citation statements)

References 8 publications

(7 reference statements)

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“…In addition, it has been recommended that the delivery catheter be deeply placed into the IMA side-branch before deploying the coil, thereby insuring that the coil will not protrude into the parent IMA [13,27]. In fact, this occurred during our first case as well.…”

Section: Discussionmentioning

confidence: 79%

“…There are several reported cases of coronary steal attributed to the presence of large IMA side-branches in the literature [6][7][8][12][13][14][15][16][17][18][19][20][21][22][27][28][29][30]. Large IMA sidebranches have been noted to be present in up to 9% (41/459) of patients on preoperative angiography [23].…”

Section: Discussionmentioning

confidence: 99%

“…Transcatheter occlusion of these sidebranches was first reported in 1990 using non-retractable and non-fibered vascular occlusion coils [8,13,14,[18][19][20][21]30]. Since then, several investigators have used alcohol infusion, silicone (or water/contrast mix) balloon embolization, gelfoam embolization, or alternative occlusive coil designs to occlude these arteries [10,[15][16][17]22,[27][28][29]. None of these approaches have been found to be predictably successful.…”

Section: Discussionmentioning

confidence: 99%

“…Not only is it highly dependent upon guide catheter support, but the most commonly used coils today are non-retractable, deployed with the use of a ''pusherwire.'' This can be particularly problematic should the delivery catheter prolapse into the native IMA [13,27]. One potential solution may be substitution of a stiffer deployment catheter, such as the Turbo-Tracker (Target Therapeutics, Fremont, CA) infusion catheter which incorporates a coiled-wire design into catheter wall for greater stability.…”

Section: Discussionmentioning

confidence: 99%

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Coronary steal by IMA bypass graft side-branches: A novel therapeutic use of a new detachable embolization coil

Eisenhauer

Mego

Cambier

1998

Cathet. Cardiovasc. Diagn.

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Section: Discussionmentioning

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Coronary steal by IMA bypass graft side-branches: A novel therapeutic use of a new detachable embolization coil

Eisenhauer

Mego

Cambier

1998

Cathet. Cardiovasc. Diagn.

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“…[2][3][4][5] A number of case reports have appeared in the literature showing that successful embolization of side branches was able to relieve the symptoms. 6,7 However, several investigators have reported that coronary flow was not affected by the side branches of the LITA. 8,9 Ivert et al performed an angiographic follow-up study of LITA grafts and found that patients were asymptomatic after 11 years in spite of unligated LITA side branches.…”

Section: Discussionmentioning

confidence: 99%

Doppler Features of Occlusion of the Internal Thoracic Artery due to Preoperative Branch Embolization

et al. 1999

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he left internal thoracic artery (LITA) procedure is now generally accepted for grafts, having longterm patency in coronary artery bypass grafting (CABG). In particular, it is considered the most suitable graft for the left anterior descending coronary artery (LAD). 1 However, postoperative coronary steal due to unligated side branches of the LITA graft has been reported. [2][3][4][5] We performed selective transcatheter embolization of a large branch of the LITA preoperatively, and detected postembolization LITA occlusion based on changes of the Doppler wave form. In this paper, we discuss the validity of LITA branch embolization, as well as reviewing the relevant literature. Case ReportA 61-year-old male was referred to the surgical ward because of a diagnosis that surgery for angina pectoris was indicated. He had an old myocardial infarction and suffered from hypertension, hyperlipidemia, and diabetes mellitus as coronary risk factors. Preoperative coronary angiography (CAG) revealed significant stenosis of the LAD and segment 2 of the right coronary artery (RCA). On the left ventriculogram, global wall motion was severely hypokinetic and the ejection fraction (EF) was 26%. On preoperative angiography of the LITA, a large first intercostal branch was found at the proximal portion, which had a diameter bigger than that of the LITA itself. We considered that the Japanese Circulation Journal Vol.63, October 1999 patient's hemodynamics would deteriorate if the coronary steal phenomenon occurred postoperatively, because his cardiac function was already quite poor. Therefore, selective arterial embolization of the branch of the LITA with a micro coil and cyanoacrylate was carried out preoperatively (Fig 1). At 2 days after embolization, transthoracic pulsed Doppler echocardiography was performed using an Acuson Sequoia C256 machine equipped with a 6 MHz transducer. The Doppler wave form at the 2nd intercostal space of the grafted LITA, obtained by the transthoracic approach, showed a biphasic pattern with a higher systolic and a lower diastolic component. The diameter of the LITA was larger than before the procedure (Fig 2) and the Doppler peak flow velocity was increased above that before embolization.Jpn Circ J 1999; 63: 819 -821 (Received May 17, 1999; revised manuscript received June 28, 1999; accepted July 19, 1999) The Second Department of Surgery, Nihon University, School of Medicine, Tokyo, Japan Mailing address: Mitsumasa Hata, MD, 30-1 Ooyaguchi Kamimashi, Itabashi-ku, Tokyo 173-8610, Japan. T Doppler Features of Occlusion of the Internal Thoracic Artery due to Preoperative Branch EmbolizationMitsumasa Hata, MD; Motomi Shiono, MD; Yukihiko Orime, MD; Tomonori Yamamoto, MD; Shinya Yagi, MD; Shunichi Kimura, MD; Haruhiko Okumura, MD; Satoshi Kashiwazaki, MD; Shinsuke Choh, MD; Tetsuya Niino, MD; Hideo Kohno, MD; Nanao Negishi, MD; Yukiyasu Sezai, MD A 61-year-old male was referred to the surgical ward by cardiologists because of a diagnosis of unstable angina with 3-vessel disease. On preoperative lef...

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Does a LIMA side branch ever need occlusion? (Why I don't think so)

Kern

1998

Cathet. Cardiovasc. Diagn.

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Novel technique for coil embolization of intercostal branch of internal mammary artery graft

Cited by 8 publications

References 8 publications

Coronary steal by IMA bypass graft side-branches: A novel therapeutic use of a new detachable embolization coil

Coronary steal by IMA bypass graft side-branches: A novel therapeutic use of a new detachable embolization coil

Doppler Features of Occlusion of the Internal Thoracic Artery due to Preoperative Branch Embolization

Does a LIMA side branch ever need occlusion? (Why I don't think so)

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