Interventional Traps in Ectatic Coronary Arteries: A Case Report

Coronary artery ectasia or aneurysms are dilatation of an arterial segment to a diameter at least 1.5 times that of the adjacent normal. Blood flow through such arteries is disturbed and turbulent, which, with the activation of endothelium, leads to chronic thrombosis in the blood vessel wall. Pe...

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Main Authors: Krešimir Gabaldo, Marijana Knežević Praveček, Domagoj Vučić, Domagoj Mišković, Ivan Bitunjac, Ivica Dunđer, Božo Vujeva, Blaženka Miškić, Katica Cvitkušić Lukenda
Format: Article
Language:English
Published: Sestre Milosrdnice University hospital, Institute of Clinical Medical Research 2024-01-01
Series:Acta Clinica Croatica
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Online Access:https://hrcak.srce.hr/file/464204
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author Krešimir Gabaldo
Marijana Knežević Praveček
Domagoj Vučić
Domagoj Mišković
Ivan Bitunjac
Ivica Dunđer
Božo Vujeva
Blaženka Miškić
Katica Cvitkušić Lukenda
author_facet Krešimir Gabaldo
Marijana Knežević Praveček
Domagoj Vučić
Domagoj Mišković
Ivan Bitunjac
Ivica Dunđer
Božo Vujeva
Blaženka Miškić
Katica Cvitkušić Lukenda
author_sort Krešimir Gabaldo
collection DOAJ
description Coronary artery ectasia or aneurysms are dilatation of an arterial segment to a diameter at least 1.5 times that of the adjacent normal. Blood flow through such arteries is disturbed and turbulent, which, with the activation of endothelium, leads to chronic thrombosis in the blood vessel wall. Percutaneous coronary interventions in ectatic / aneurysmal vessels carry a high risk of complications, primarily a “no-reflow” phenomenon. No-reflow is common in patients with acute coronary syndrome, especially ST elevation myocardial infarction (STEMI). In this article, we present the occurrence of the no-reflow phenomenon in a stable patient undergoing percutaneous intervention due to a significant stenosis of the aneurysmally altered right coronary artery. Despite the rapid placement and optimization of stents and the applied drug therapy combined with thromboaspiration periprocedurally, it was not possible to establish TIMI 3 flow. However, after the initial failure and development of periprocedural STEMI, the patient was successfully stabilized with unexpectedly good recovery of infarcted myocardial function. Control coronarography 6 weeks after the initial event confirmed a proper stent patency with normal TIMI 3 flow.
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publishDate 2024-01-01
publisher Sestre Milosrdnice University hospital, Institute of Clinical Medical Research
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spelling doaj-art-96ea3c9faf3342cbbd6c3b9c72d29b782025-08-20T02:15:11ZengSestre Milosrdnice University hospital, Institute of Clinical Medical ResearchActa Clinica Croatica0353-94661333-94512024-01-0163.Supplement 1707410.20471/acc.2024.63.s1.13Interventional Traps in Ectatic Coronary Arteries: A Case ReportKrešimir Gabaldo0Marijana Knežević Praveček1Domagoj Vučić2Domagoj Mišković3Ivan Bitunjac4Ivica Dunđer5Božo Vujeva6Blaženka Miškić7Katica Cvitkušić Lukenda8Department of Internal Medicine, Dr. Josip Benčević General Hospital, Slavonski Brod, Croatia; Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Osijek, CroatiaDepartment of Internal Medicine, Dr. Josip Benčević General Hospital, Slavonski Brod, Croatia; Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Osijek, CroatiaDepartment of Internal Medicine, Dr. Josip Benčević General Hospital, Slavonski Brod, Croatia; Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; University Postgraduate Interdisciplinary Doctoral Study Programme in Molecular Biosciences, Josip Juraj Strossmayer University of Osijek, Osijek, CroatiaDepartment of Internal Medicine, Dr. Josip Benčević General Hospital, Slavonski Brod, Croatia; Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Osijek, CroatiaDepartment of Internal Medicine, Dr. Josip Benčević General Hospital, Slavonski Brod, Croatia; Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Osijek, CroatiaDepartment of Internal Medicine, Dr. Josip Benčević General Hospital, Slavonski Brod, CroatiaDepartment of Internal Medicine, Dr. Josip Benčević General Hospital, Slavonski Brod, CroatiaDepartment of Internal Medicine, Dr. Josip Benčević General Hospital, Slavonski Brod, Croatia; Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Osijek, CroatiaDepartment of Internal Medicine, Dr. Josip Benčević General Hospital, Slavonski Brod, Croatia; Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; University Postgraduate Interdisciplinary Doctoral Study Programme in Molecular Biosciences, Josip Juraj Strossmayer University of Osijek, Osijek, CroatiaCoronary artery ectasia or aneurysms are dilatation of an arterial segment to a diameter at least 1.5 times that of the adjacent normal. Blood flow through such arteries is disturbed and turbulent, which, with the activation of endothelium, leads to chronic thrombosis in the blood vessel wall. Percutaneous coronary interventions in ectatic / aneurysmal vessels carry a high risk of complications, primarily a “no-reflow” phenomenon. No-reflow is common in patients with acute coronary syndrome, especially ST elevation myocardial infarction (STEMI). In this article, we present the occurrence of the no-reflow phenomenon in a stable patient undergoing percutaneous intervention due to a significant stenosis of the aneurysmally altered right coronary artery. Despite the rapid placement and optimization of stents and the applied drug therapy combined with thromboaspiration periprocedurally, it was not possible to establish TIMI 3 flow. However, after the initial failure and development of periprocedural STEMI, the patient was successfully stabilized with unexpectedly good recovery of infarcted myocardial function. Control coronarography 6 weeks after the initial event confirmed a proper stent patency with normal TIMI 3 flow.https://hrcak.srce.hr/file/464204AneurysmsAcute coronary syndromeThromboaspirationNo-reflow
spellingShingle Krešimir Gabaldo
Marijana Knežević Praveček
Domagoj Vučić
Domagoj Mišković
Ivan Bitunjac
Ivica Dunđer
Božo Vujeva
Blaženka Miškić
Katica Cvitkušić Lukenda
Interventional Traps in Ectatic Coronary Arteries: A Case Report
Acta Clinica Croatica
Aneurysms
Acute coronary syndrome
Thromboaspiration
No-reflow
title Interventional Traps in Ectatic Coronary Arteries: A Case Report
title_full Interventional Traps in Ectatic Coronary Arteries: A Case Report
title_fullStr Interventional Traps in Ectatic Coronary Arteries: A Case Report
title_full_unstemmed Interventional Traps in Ectatic Coronary Arteries: A Case Report
title_short Interventional Traps in Ectatic Coronary Arteries: A Case Report
title_sort interventional traps in ectatic coronary arteries a case report
topic Aneurysms
Acute coronary syndrome
Thromboaspiration
No-reflow
url https://hrcak.srce.hr/file/464204
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AT marijanaknezevicpravecek interventionaltrapsinectaticcoronaryarteriesacasereport
AT domagojvucic interventionaltrapsinectaticcoronaryarteriesacasereport
AT domagojmiskovic interventionaltrapsinectaticcoronaryarteriesacasereport
AT ivanbitunjac interventionaltrapsinectaticcoronaryarteriesacasereport
AT ivicadunđer interventionaltrapsinectaticcoronaryarteriesacasereport
AT bozovujeva interventionaltrapsinectaticcoronaryarteriesacasereport
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