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Case Reports
Published online: 2019-03-27
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Can nominal burst pressure guarantee against dissection during percutaneous transluminal coronary angioplasty?

Santosh Kumar Sinha, Anupam Mahrotra, Mahmodula Razi, Puneet Aggarwal, Lokendra Rekwaal, Sunil Tripathi
DOI: 10.5603/FC.a2019.0024

open access

Ahead of print
Case Reports
Published online: 2019-03-27

Abstract

A 68 year-old male with hypertension, dyslipidemia, and current smoking as coronary risk factors was referred for coronary angiography (CAG) in lieu of chronic stable angina. He was Canadian Cardiovascular Society class III despite guideline-directed medical treatment. The CAG revealed a critical stenotic lesion (90%) in the proximal left circumflex (LCx) coronary artery with mild calcification. A 3.5 × 23 mm Xience prime drug-eluting stent (Abbott Vascular, USA) was deployed at 8 atm. Duringthe procedure, he developed chest pain. Angiogram revealed a long spiral dissection starting from the distal edge of the stent. To bail out, another overlapping 3 × 38 mm Xience prime stentwas deployed at 10 atm pressure, showing proper stent expansion and no residual dissection flap with TIMI-3 coronary flow. This case highlights that dissection can occur in a calcified vessel even below the nominal pressure which could be successfully bailed out by implantation with another coronary stent with complete cover of the coronary dissection.

Abstract

A 68 year-old male with hypertension, dyslipidemia, and current smoking as coronary risk factors was referred for coronary angiography (CAG) in lieu of chronic stable angina. He was Canadian Cardiovascular Society class III despite guideline-directed medical treatment. The CAG revealed a critical stenotic lesion (90%) in the proximal left circumflex (LCx) coronary artery with mild calcification. A 3.5 × 23 mm Xience prime drug-eluting stent (Abbott Vascular, USA) was deployed at 8 atm. Duringthe procedure, he developed chest pain. Angiogram revealed a long spiral dissection starting from the distal edge of the stent. To bail out, another overlapping 3 × 38 mm Xience prime stentwas deployed at 10 atm pressure, showing proper stent expansion and no residual dissection flap with TIMI-3 coronary flow. This case highlights that dissection can occur in a calcified vessel even below the nominal pressure which could be successfully bailed out by implantation with another coronary stent with complete cover of the coronary dissection.

Get Citation

Keywords

calcium; chronic stable angina; nominal pressure; spiral dissection; stent

About this article
Title

Can nominal burst pressure guarantee against dissection during percutaneous transluminal coronary angioplasty?

Journal

Folia Cardiologica

Issue

Ahead of print

Published online

2019-03-27

DOI

10.5603/FC.a2019.0024

Keywords

calcium
chronic stable angina
nominal pressure
spiral dissection
stent

Authors

Santosh Kumar Sinha
Anupam Mahrotra
Mahmodula Razi
Puneet Aggarwal
Lokendra Rekwaal
Sunil Tripathi

References (8)
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