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  • Mac Chi

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    serena7205
    18 vues2 pages
    A 70-year-old man with risk factors for cardiovascular disease underwent coronary angiography and angioplasty due to exercise-induced angina. During the procedure, the operator encountered resistance when inserting the guidewire, and imaging revealed an iliac artery "volvolus", or coiling, on the right side. An extra-long direct stent was successfully placed to treat a stenosis in the left anterior descending artery. Follow-up imaging showed the iliac artery coiling but no complications, and the patient remained symptom-free at 12 months.

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    A 70-year-old man with risk factors for cardiovascular disease underwent coronary angiography and angioplasty due to exercise-induced angina. During the procedure, the operator encountered resistance when inserting the guidewire, and imaging revealed an iliac artery "volvolus", or coiling, on the right side. An extra-long direct stent was successfully placed to treat a stenosis in the left anterior descending artery. Follow-up imaging showed the iliac artery coiling but no complications, and the patient remained symptom-free at 12 months.

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    18 vues2 pages

    Mac Chi

    Transféré par

    serena7205
    A 70-year-old man with risk factors for cardiovascular disease underwent coronary angiography and angioplasty due to exercise-induced angina. During the procedure, the operator encountered resistance when inserting the guidewire, and imaging revealed an iliac artery "volvolus", or coiling, on the right side. An extra-long direct stent was successfully placed to treat a stenosis in the left anterior descending artery. Follow-up imaging showed the iliac artery coiling but no complications, and the patient remained symptom-free at 12 months.

    Droits d'auteur :

    Attribution Non-Commercial (BY-NC)
    Téléchargez comme PDF, TXT ou lisez en ligne sur Scribd
    Signaler comme contenu inapproprié
    sur 2

    proceedings

    in Intensive Care
    Cardiovascular Anesthesia

    CASE REPORT
    Endorsed by

    1
    Coronary angiography
    and angioplasty in a patient
    with an iliac artery volvolus
    I. Franzoni, F. Baratto, A. Macchi, I. Rosa, F. Buzzetti, A. Margonato
    Department of Cardiology and Coronary Care Unit, Università Vita-Salute San Raffaele, Milan, Italy

    ABSTRACT
    A 70-year-old Caucasian male underwent to percutaneous revascularization through arterial iliac “volvolus”
    by extralong direct stenting using a long 8 french introducer with an optimal angiographic result and clinical
    outcome.

    Keywords: coronary angioplasty, iliac artery tortuosity.

    A 70-year-old Caucasian male with hyper- evident (Panel B). A right iliac artery vol-
    tension, hyperlipidemia, permanent atrial volus was evident, aortic carrefour was
    fibrillation and recent onset of exercise shifted to the right, left iliac artery was
    angina with a positive stress test was ad- longer than normal (Panel C).
    mitted to our department to undergo cor- Artery diameter was large, flow was pre-
    onary-angiography. He was asymptomatic served. Coronary angiography was per-
    for claudicatio intermittens, the physical formed by a long 8 french introducer (65
    examination revealed only a systolic api- cm) that permitted a fine engagement of
    cal murmur, no other vascular murmure coronary ostia and showed a critical steno-
    was evident. sis of the proximal tract of left anterior de-
    Transthoracic echocardiography showed a scending artery. Using an 8 french sheath,
    normal cardiac systolic function (left ven- a good back up was achieved and percuta-
    tricular ejection fraction 60%) with mod- neous revascularization was performed by
    erate mitralic regurgitation. extralong direct stenting (paclitaxel drug
    He undewent coronary catheterization, eluting stent 3 x 38 mm), with an opti-
    but the operator felt resistance while in- mal angiographic result (TIMI 3 flow) and
    troducing the guide wire through the right clinical outcome.
    femoral superficial artery 6 french sheath. On the next day the patient underwent
    Panel A shows the appearance of the guide echo-color-doppler of inferior limbs arter-
    immediately after insertion. ies that showed coiling of the right iliac ar-
    After injecting contrast medium, a bizarre tery and absence of any vascular complica-
    anatomy of patient’s iliac artery became tion (Panel D).
    Corresponding author:
    At the 12 months follow up, the patient is
    Andrea Macchi, MD asymptomatic for angina and claudicatio
    Department of Cardiology and Coronary Care Unit
    Istituto Scientifico San Raffaele, intermittens.
    Via Olgettina, 60 - 20132 Milan, Italy
    e.mail: macchi.andrea@hsr.it No conflict of interest is acknowledged by the authors.
    I. Franzoni, et al.

    Apparent interruption of right iliac artery (A) and iliac “volvolus” (B).

    Right iliac artery. Post procedural Echo-color-Doppler of right iliac


    artery.

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