Emergency bail-out stenting for major coronary dissection complicating rotational atherectomy. 1995

C J McKenna, and H A McCann, and D D Sugrue
Department of Clinical Cardiology, Mater Misericordiae Hospital (University College), Dublin.

The problems of restenosis and abrupt occlusion following percutaneous transluminal coronary angioplasty (PTCA) remain a challenge. Restenosis occurs in 30-50% of lesions treated and substantially erodes the potential advantage of percutaneous treatment of obstructive coronary disease over alternative revascularisation strategies. Abrupt closure occurs in 5-7% of cases with significant associated morbidity and mortality. Up to 35% of patients require emergency bypass surgery for treatment of abrupt closure and more than half sustain a perioperative myocardial infarction. By debulking atherosclerotic lesions, atherectomy offers the potential to reduce restenosis. Coronary stenting, by acting as a scaffolding can sometimes solve the problem of abrupt closure due to intimal dissection. We report the use of emergency placement of multiple coronary stents for obstructive coronary dissection complicating rotational atherectomy.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D003323 Coronary Aneurysm Abnormal balloon- or sac-like dilatation in the wall of CORONARY VESSELS. Most coronary aneurysms are due to CORONARY ATHEROSCLEROSIS, and the rest are due to inflammatory diseases, such as KAWASAKI DISEASE. Aneurysm, Coronary,Aneurysms, Coronary,Coronary Aneurysms
D004630 Emergencies Situations or conditions requiring immediate intervention to avoid serious adverse results. Emergency
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000784 Aortic Dissection A tear in the inner layer of the AORTA leading to interstitial HEMORRHAGE, and splitting (dissecting) of the aortic TUNICA MEDIA layer. It typically begins with a tear in the TUNICA INTIMA layer. Aneurysm, Dissecting,Aortic Dissecting Aneurysm,Dissecting Aneurysm,Dissecting Aneurysm Aorta,Aneurysm Aorta, Dissecting,Aneurysm, Aortic Dissecting,Aorta, Dissecting Aneurysm,Aortic Dissecting Aneurysms,Aortic Dissections,Dissecting Aneurysm Aortas,Dissecting Aneurysm, Aortic,Dissecting Aneurysms,Dissection, Aortic
D015607 Stents Devices that provide support for tubular structures that are being anastomosed or for body cavities during skin grafting. Stent
D015906 Angioplasty, Balloon, Coronary Dilation of an occluded coronary artery (or arteries) by means of a balloon catheter to restore myocardial blood supply. Angioplasty, Coronary Balloon,Angioplasty, Transluminal, Percutaneous Coronary,Coronary Angioplasty, Transluminal Balloon,Percutaneous Transluminal Coronary Angioplasty,Balloon Dilation, Coronary Artery,Transluminal Coronary Balloon Dilation,Angioplasties, Coronary Balloon,Balloon Angioplasties, Coronary,Balloon Angioplasty, Coronary,Coronary Balloon Angioplasties,Coronary Balloon Angioplasty
D017225 Atherectomy, Coronary Percutaneous transluminal procedure for removing atheromatous plaque from the coronary arteries. Both directional (for removing focal atheromas) and rotational (for removing concentric atheromatous plaque) atherectomy devices have been used. Coronary Atherectomy,Directional Coronary Atherectomy,Rotational Atherectomy,Atherectomies, Coronary,Atherectomies, Directional Coronary,Atherectomies, Rotational,Atherectomy, Directional Coronary,Atherectomy, Rotational,Coronary Atherectomies,Coronary Atherectomies, Directional,Coronary Atherectomy, Directional,Directional Coronary Atherectomies,Rotational Atherectomies

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