Percutaneous revascularization strategies in a patient with previous coronary artery bypass surgery: Technical and patho-physiological insights Pierfrancesco.

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Date of download: 9/18/2016 Copyright © The American College of Cardiology. All rights reserved. From: Percutaneous Treatment of Protected and Unprotected.

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Presentation transcript:

Percutaneous revascularization strategies in a patient with previous coronary artery bypass surgery: Technical and patho-physiological insights Pierfrancesco Agostoni, Paul Vermeersch, Frank Van den Branden International Journal of Cardiology Volume 137, Issue 1, Pages e23-e26 (September 2009) DOI: 10.1016/j.ijcard.2008.05.046 Copyright © 2008 Elsevier Ireland Ltd Terms and Conditions

Fig. 1 Baseline coronary angiography showing severe stenoses of the right coronary artery (A) and of the left main, left anterior descendens and circumflex arteries (B). International Journal of Cardiology 2009 137, e23-e26DOI: (10.1016/j.ijcard.2008.05.046) Copyright © 2008 Elsevier Ireland Ltd Terms and Conditions

Fig. 2 Coronary angiogram 20 months after surgery, showing an occluded left main (A), an occluded right coronary artery in its mid-part (B), a severe stenosis of the ostium of the saphenous vein graft on the right coronary artery (C) and the same venous conduit after percutaneous treatment with bare metal stent implantation (D). International Journal of Cardiology 2009 137, e23-e26DOI: (10.1016/j.ijcard.2008.05.046) Copyright © 2008 Elsevier Ireland Ltd Terms and Conditions

Fig. 3 New coronary angiogram 4 months after the stenting procedure, showing a stenotic but patent right coronary artery (A) and a flow-limiting sub-occlusive in-stent restenosis of the saphenous vein graft on the right coronary artery (B). International Journal of Cardiology 2009 137, e23-e26DOI: (10.1016/j.ijcard.2008.05.046) Copyright © 2008 Elsevier Ireland Ltd Terms and Conditions

Fig. 4 Severe spiral dissection of the whole right coronary artery after pre-dilatation with an undersized balloon. International Journal of Cardiology 2009 137, e23-e26DOI: (10.1016/j.ijcard.2008.05.046) Copyright © 2008 Elsevier Ireland Ltd Terms and Conditions

Fig. 5 Reestablished flow in the distal saphenous vein graft on the right coronary artery after balloon angioplasty of the in-stent restenosis (A), and final result after placement of a zotarolimus-eluting stent to treat the same lesion (B). International Journal of Cardiology 2009 137, e23-e26DOI: (10.1016/j.ijcard.2008.05.046) Copyright © 2008 Elsevier Ireland Ltd Terms and Conditions