Two Different Successful Angioplasty Methods in Patients with Stenotic Coronary Artery Ectasia

Abstract

There is no current guideline for percutaneous coronary angioplasty in stenotic ectatic coronary arteries because of the heterogeneity of the coronary artery morphology. We report two successful angioplasty cases in coronary artery ectasia with different clinical scenarios. One case showed atherosclerotic stenosis in the ectatic portion of the right coronary artery that was aggravated after a coronary artery bypass graft. In this case, balloon angioplasty alone without stenting showed acceptable results at the 6-month follow-up coronary angiography. In the other case, we used a peripheral artery balloon and stent for stenosis in the ectatic portion of a large coronary artery. Six-month follow-up coronary angiography showed excellent patency of the previously implanted peripheral stent.

Coronary Artery Ectasia in Atherosclerotic Coronary Artery Disease, Inflammatory Disorders, and Sickle Cell Disease

“…Stent implantation or attempts to aspirate the thrombus carry the risk of distal thromboembolization [9,22]. Although there are some reports of successful transluminal extraction catheter atherectomy or good outcome with balloon angioplasty without stenting in selective cases, but overall, acute occlusion of a dilated coronary artery is associated with lower success rates due to the large thrombus burden [9,22,92,94,95]. Furthermore, it was noted that patients with atherosclerotic CAE were less likely to undergo percutaneous transluminal coronary angioplasty compared with their peers who had a comparable severity of obstructive ACAD without ectasia [4].…”

ST-Segment Elevation Myocardial Infarction as a Result of Coronary Artery Ectasia-Related Intracoronary Thrombus in a Patient with Liver Cirrhosis

“…Although balloon angioplasty and stent implantation or attempting thrombus aspiration carries the risk of distal thromboembolization, some reports have demonstrated favorable outcomes obtained by successful thrombus removal or using balloon angioplasty with or without stenting. [19] In addition, intracoronary infusion of glycoprotein IIb/IIIa inhibitors is safe and effective for ACS patients who have a large intracoronary thrombus. [20] Therefore, percutaneous revascularization or surgical approaches should be considered depending on the structure or shape of the coronary artery, pathophysiology, and the patient's clinical condition.…”

Primary Angioplasty Using a Renal Stent in a Severly Ectactic and Occluded Left Anterior Descending Coronary Artery

“…1 It is found to occur in 1.2-4.7% of patients undergoing coronary angiography (CAG) . 2 The etiologies of CAE are atherosclerosis in 50% cases, congenital in 20-30% while 10-20% are associated with connective tissue disorders.…”