Case report: coronary artery dissection complicating stent implantation and percutaneous coronary intervention with hematoma in the distal right coronary artery
1 International Education College, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang, China.
2 First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310001, Zhejiang, China.
3 Department of Cardiology, First Affiliated Hospital, Zhejiang Chinese Medical University, Hangzhou 310001, Zhejiang, China.
Case Report
World Journal of Biology Pharmacy and Health Sciences, 2024, 20(03), 687-692.
Article DOI: 10.30574/wjbphs.2024.20.3.1068
Publication history:
Received on 12 November 2024; revised on 27 December 2024; accepted on 30 December 2024
Abstract:
Coronary artery angiography (CAG)/ percutaneous coronary intervention (PCI) and stent placement for restenosis is an important means of diagnosis and treatment of coronary heart disease. The case presents a 61-year-old woman with coronary artery disease who presented with recurrent wheezing, chest tightness, palpitations, and a sensation of pharyngeal blockage. A recent coronary artery computed tomography angiography (CTA) indicated CAD-RADS grade 4 coronary atherosclerosis, characterized by calcified plaques and varying degrees of stenosis in the left main trunk, left anterior descending artery (LAD), left circumflex artery (LCX), and right coronary artery (RCA). The patient exhibited intermittent T-wave changes on a dynamic electrocardiogram, leading to her admission for treatment and complete coronary angiography. The angiography revealed significant stenosis in the LAD, diffuse plaque lesions in the LCX, and dissection from the middle to distal RCA, confirming spontaneous coronary artery dissection (SCAD). The patient underwent a two-stent procedure, which resulted in favorable outcomes with TIMI flow grade 3 observed in the RCA. Additionally, balloon angioplasty, stenting, multi-catheter angiography, and percutaneous coronary intervention (PCI) were performed to address proximal-mid RCA dissection with intramural hematoma. The case study concludes by highlighting the successful management of severe RCA stenosis, dissection, and hematoma using a PCI strategy for SCAD.
Keywords:
Percutaneous coronary intervention; Drug-eluting stents; Balloon angioplasty; Bioabsorbable stent; Spontaneous coronary artery dissection; Strategy
Full text article in PDF:
Copyright information:
Copyright © 2024 Author(s) retain the copyright of this article. This article is published under the terms of the Creative Commons Attribution Liscense 4.0