Korean Circ J.  2011 Jan;41(1):34-37. 10.4070/kcj.2011.41.1.34.

Stenting of the Left Main Coronary Artery in a Patient With Takayasu's Arteritis

• Lee HK
• Namgung J
• Choi WH
• Choe H
• Kwon SU
• Doh JH
• Lee SY
• Lee WR

• KMID: 2225152
• DOI: http://doi.org/10.4070/kcj.2011.41.1.34

Abstract

Management of Takayasu's arteritis of the left main coronary artery (LMCA) is difficult because of the possibility of restenosis. Clinically significant stenotic lesions must be considered anatomical correlation. Many studies have reported that the management of stenotic lesions of the LMCA with endoluminal stenting and balloon angioplasty and de-novo stenting is safe and effective for patients with Takayasu's arteritis. We report the case of a patient with Takayasu's arteritis of the LMCA. The patient had undergone two consecutive percutaneous coronary interventions because of recurrent restenosis of in-stent lesions, and eventually underwent coronary artery bypass graft (CABG) surgery for myocardial infarction in the same lesion. We suggested treatment with CABG because the pathophysiology of Takayasu's arteritis is different from that of atherosclerotic stenosis.

Keyword

Takayasu arteritis; Coronary artery disease; Percutaneous transluminal coronary angioplasty

MeSH Terms

Angioplasty, Balloon
Angioplasty, Balloon, Coronary
Constriction, Pathologic
Coronary Artery Bypass
Coronary Artery Disease
Coronary Vessels
Humans
Myocardial Infarction
Percutaneous Coronary Intervention
Stents
Takayasu Arteritis
Transplants

Figure

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  Fig. 1 Angiography of the right subclavian artery show total occlusion (black arrow) near the origin and marked dilation of the collateral artery (white arrows) originating from the thyrocervical trunk in the early phase (A) and a reconstituted axillary artery (black arrow) via dilated collaterals (white arrow) in later phase (B).

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  Fig. 2 Angiography of the left coronary angiography show focal stenosis in the ostium of left main coronary artery (A) and a paclitaxel-eluting stent deployed in the ostium of the left main coronary artery (B).

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  Fig. 3 A follow-up coronary angiography shows 75% segmental stenosis in the proximal portion of the in-stent lesion area (A) and another paclitaxel-eluting stent (TAXUS™) deployed in the in-stent lesion (B).

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  Fig. 4 Coronary angiography shows tight insent restenosis after second intervention in the ostium of the left main coronary artery.

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