open access

Ahead of print
Case Reports
Published online: 2019-07-02
Get Citation

TAP-stenting as bail-out strategy for iatrogenic dissection of left main bifurcation

Santosh Kumar Sinha, Kumar Himanshu, Sunil Tripathi, Puneet Aggarwal, Mahmodulla Razi
DOI: 10.5603/FC.a2019.0077

open access

Ahead of print
Case Reports
Published online: 2019-07-02

Abstract

Iatrogenic coronary dissection is a rare but potentially catastrophic complication of percutaneous coronary intervention. The proximal left anterior descending artery (LAD) dissection may extend into distal left main bifurcation which may further engulf left circumflex artery (LCx). Here, we report a case of a 69-year-old male where dissection at proximal edge of well deployed stent led to total closure of left circumflex artery causing hemodynamic compromise. It was bailed out using T-and-protrusion (TAP) stenting where LAD and LCx were stented using 3.5x12mm and 3x24 mm sirolimus-eluting stent (Yukon Choice, Translumina) respectively. TAP technique is a feasible and reasonable management strategy for immediate bail-out stenting for this lethal complication

Abstract

Iatrogenic coronary dissection is a rare but potentially catastrophic complication of percutaneous coronary intervention. The proximal left anterior descending artery (LAD) dissection may extend into distal left main bifurcation which may further engulf left circumflex artery (LCx). Here, we report a case of a 69-year-old male where dissection at proximal edge of well deployed stent led to total closure of left circumflex artery causing hemodynamic compromise. It was bailed out using T-and-protrusion (TAP) stenting where LAD and LCx were stented using 3.5x12mm and 3x24 mm sirolimus-eluting stent (Yukon Choice, Translumina) respectively. TAP technique is a feasible and reasonable management strategy for immediate bail-out stenting for this lethal complication

Get Citation

Keywords

Iatrogenic coronary dissection; Left main bifurcation; TAP stenting; left anterior descending artery

About this article
Title

TAP-stenting as bail-out strategy for iatrogenic dissection of left main bifurcation

Journal

Folia Cardiologica

Issue

Ahead of print

Published online

2019-07-02

DOI

10.5603/FC.a2019.0077

Keywords

Iatrogenic coronary dissection
Left main bifurcation
TAP stenting
left anterior descending artery

Authors

Santosh Kumar Sinha
Kumar Himanshu
Sunil Tripathi
Puneet Aggarwal
Mahmodulla Razi

References (7)
  1. Liao MT, Liu SC, Lee JK, et al. Aortocoronary dissection with extension to the suprarenal abdominal aorta: a rare complication after percutaneous coronary intervention. JACC Cardiovasc Interv. 2012; 5(12): 1292–1293.
  2. Eshtehardi P, Adorjan P, Togni M, et al. Iatrogenic left main coronary artery dissection: incidence, classification, management, and long-term follow-up. Am Heart J. 2010; 159(6): 1147–1153.
  3. Lassen JF, Holm NR, Banning A, et al. Percutaneous coronary intervention for coronary bifurcation disease: 11th consensus document from the European Bifurcation Club. EuroIntervention. 2016; 12(1): 38–46.
  4. Burzotta F, Džavík V, Ferenc M, et al. Technical aspects of the T And small Protrusion (TAP) technique. EuroIntervention. 2015; 11 Suppl V: V91–V95.
  5. Ferenc M, Ayoub M, Büttner HJ, et al. Randomized trial on routine vs. provisional T-stenting in the treatment of de novo coronary bifurcation lesions. Eur Heart J. 2008; 29(23): 2859–2867.
  6. Burzotta F, Gwon HC, Hahn JY, et al. Modified T-stenting with intentional protrusion of the side-branch stent within the main vessel stent to ensure ostial coverage and facilitate final kissing balloon: the T-stenting and small protrusion technique (TAP-stenting). Report of bench testing and first clinical Italian-Korean two-centre experience. Catheter Cardiovasc Interv. 2007; 70(1): 75–82.
  7. Chen X, Zhang D, Yin D, et al. Can "true bifurcation lesion" actually be regarded as an independent risk factor of acute side branch occlusion after main vessel stenting?: A retrospective analysis of 1,200 consecutive bifurcation lesions in a single center. Catheter Cardiovasc Interv. 2016; 87 Suppl 1: 554–563.

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

 

Wydawcą serwisu jest  "Via Medica sp. z o.o." sp.k., ul. Świętokrzyska 73, 80–180 Gdańsk

tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail:  viamedica@viamedica.pl