By Nick Curzen, Martin T Rothman
Considering that 1986, while stents have been first inserted into human coronary arteries, millions were implanted, as they've got turn into the common panacea for issues and for complicated lesion subsets. Illustrated all through with angiograms Coronary Artery Stenting seems on the most recent applied sciences and the ensuing advancements and difficulties. This incredible staff of foreign cardiologists think of the concept procedures in the back of the decision-making and proportion their adventure with the reader in the best way to care for complex anatomy and body structure, easy methods to conquer the issues, and while to summon more matured aid.
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Extra info for Coronary Artery Stenting: A Case-Oriented Approach
This can be accomplished by Wallstent®, or multiple stents, as has been performed in this case with an adequate angiographic result. As long as the outflow is reasonable, especially at the posterior descending branch, the likelihood of early re-occlusion is low. By contrast, the likelihood of restenosis is high, given the degree of dissection. In our experience many patients have been treated adequately in the long term with this approach of re-entry into a true lumen with the deployment of long stents.
Total chronic occlusions 40-year-old man. Smoker; family history. Inferior MI June 1996. Exertional angina May 1997. Catheter findings: Good overall LV with mild inferior hypokinesis; left coronary artery unobstructed; RCA as shown. 014Љ high torque floppy wire. 0 mm ϫ 31 mm proximally. 5 mm Chubby™ balloon. 1 RCA angiogram. a) Occluded proximal RCA. b) After disobliteration. c) Result. c Ian M Penn: Although this occlusion is over a year old, the appearance on the angiogram, that of haziness with no major collaterals or side branches beyond the conus branch, is of a recent occlusion.
014Љ high torque floppy wire. 0 mm monorail balloon. 5 mm ϫ 15 mm in first diagonal branch. Ulrich Sigwart and Carl Brookes: This is a case of two vessel disease with a very tight circumflex lesion and long tubular LAD stenosis. In the elective setting both vessels could be done in one session as neither lesion is particularly complex. This is not a case for a staged procedure as everything can be done with one guiding catheter and it would not necessarily be a long procedure. In general, the radiation dose and the contrast load are the two main factors that govern whether or not we would perform a staged procedure.