Author/Authors :
Alemzadeh-Ansari, Mohammad Javad Cardiovascular Intervention Research Center - Rajaie Cardiovascular, Medical, and Research Center - Iran University of Medical Sciences, Tehran, IR Iran , Norouzi, Zeinab Rajaie Cardiovascular, Medical, and Research Center - Iran University of Medical Sciences, Tehran, IR Iran , Salehi, Pegah Rajaie Cardiovascular, Medical, and Research Center - Iran University of Medical Sciences, Tehran, IR Iran , Baharestani, Bahador Rajaie Cardiovascular, Medical, and Research Center - Iran University of Medical Sciences, Tehran, IR Iran , Mohebbi, Bahram Cardiovascular Intervention Research Center - Rajaie Cardiovascular, Medical, and Research Center - Iran University of Medical Sciences, Tehran, IR Iran
Abstract :
A 60-year-old man presented with typical chest pain of the New York Heart Association function class III. The patient mentioned a history of stroke, hypertension, hyperlipidemia, and gastrointestinal bleeding. Angiography revealed a total cut in the mid-portion of the left anterior descending (LAD), a total cut in the ostial portion of the second branch of the diagonal branch of the left circumflex artery (LCX) as well as significant segmental stenosis in the mid-portion of the LCX, and also a significant lesion in the mid-portion of the right coronary artery (RCA). He was scheduled for a multivessel percutaneous coronary intervention (PCI).
The LAD was wired with a 0.014-PILOT 150 guidewire, and 2 drug-eluting stents were deployed in the LAD. Six weeks later, the patient experienced chest pain again, despite receiving full medical treatment. The next angiography showed an unexpected pseudoaneurysm, in the mid-portion of the LAD exactly at the site of the stenting performed in the previous PCI. We considered coronary artery bypass grafting given the high possibility of thrombosis in the LAD and the presence of lesions in the RCA and the LCX.
