Progression of left anterior descending artery dissection due to stent implantation for spontaneous coronary artery dissection of left circumflex artery: a case report - Archive ouverte HAL Accéder directement au contenu
Article Dans Une Revue European Heart Journal. Case Reports Année : 2019

Progression of left anterior descending artery dissection due to stent implantation for spontaneous coronary artery dissection of left circumflex artery: a case report

Résumé

Background: Spontaneous coronary artery dissection (SCAD) is a rare disease that predominantly affects woman. Percutaneous coronary intervention (PCI) is recommended only in patients with ongoing ischaemia because it carries a high risk of procedural complications in SCAD patients. Case summary: A 51-year-old woman was admitted to our institution owing to severe chest pain. Coronary angiography showed a diffuse narrowing and radiolucent luminal flap which runs parallel to the vessel wall in the proximal left circumflex coronary artery and SCAD was diagnosed. After PCI was undertaken, optical coherence tomography disclosed a circular haematoma at the stent distal segment and an intimal tear at the distal left main coronary artery. A conservative approach was decided owing to patient stability without evidence of ongoing ischaemia and normal coronary flow. Thirty minutes later, the patient started to complain of chest pain with the ST-segment elevation in leads I, aVL, and V2–3. Coronary angiography demonstrated a total occlusion of the second diagonal brunch and double lumen morphology at the proximal-potion of left anterior descending with TIMI2 distal flow suggesting the extension of coronary dissection. Optical coherence tomography imaging revealed that the entry door of the dissection was located where the small intimal tear was found. Percutaneous coronary intervention was successfully performed, and the patient was discharged without any complication. Discussion: Although the underlying mechanism of recurrent SCAD remain largely unknown, our case suggests that the residual inlet of the dissection may associate with the extension of the coronary dissection.
Fichier principal
Vignette du fichier
ytz173.pdf (586.96 Ko) Télécharger le fichier
Origine Publication financée par une institution

Dates et versions

hal-03884768 , version 1 (05-12-2022)

Licence

Identifiants

Citer

Kensuke Matsushita, Jessica Ristorto, Olivier Morel, Patrick Ohlmann. Progression of left anterior descending artery dissection due to stent implantation for spontaneous coronary artery dissection of left circumflex artery: a case report. European Heart Journal. Case Reports, 2019, 3 (4), pp.1 - 6. ⟨10.1093/ehjcr/ytz173⟩. ⟨hal-03884768⟩

Collections

INSERM SITE-ALSACE
5 Consultations
7 Téléchargements

Altmetric

Partager

Gmail Mastodon Facebook X LinkedIn More