Korean Circ J.  2018 Jun;48(6):532-533. 10.4070/kcj.2018.0016.

Intravascular Ultrasound-Guided Percutaneous Coronary Intervention with Drug-eluting Stent for Unprotected Left Main Disease via Left Snuffbox Approach

• Kim Y
• Jeong MH
• Kim I
• Kim MC
• Sim DS
• Hong YJ
• Kim JH
• Ahn Y

• KMID: 2412547
• DOI: http://doi.org/10.4070/kcj.2018.0016

Abstract

No abstract available.

MeSH Terms

Drug-Eluting Stents*
Percutaneous Coronary Intervention*

Figure

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  Figure 1 (A) Peripheral angiography of left hand demonstrating relevant caliber of distal radial artery compared with conventional puncture site of radial artery (arrow, punctured artery site of left snuffbox approach). (B) Inserted 6 French sheath via left snuffbox approach (upper) and clear wound of puncture site on next day after removal of sheath (arrow, lower). (C) Diagnostic CAG demonstrating severe stenosis in the ULMCA (arrow, upper) and post percutaneous coronary intervention CAG demonstrating successful stenting of the ULMCA (arrow, lower). (D) IVUS cross-section demonstrating minimal lumen area of 5.1 mm2 and plaque burden of 78% (PB, plaque burden). (E) IVUS after post-stent implantation with postdilation demonstrating MSA of 7.5 mm2 and significant malapposition (1.1 mm of distance between both arrowheads). (F) Stent boost imaging demonstrating under-expansion stent before 2nd postdilation (arrowheads in upper) and well-expansion after 2nd postdilatioin (arrowheads in lower). (G) Follow-up IVUS demonstrating MSA of 17.4 mm2 without malapposition. CAG = coronary angiography; IVUS = intravascular ultrasound; MSA = minimal stent area; ULMCA = unprotected left main coronary artery.

Reference

1. Kiemeneij F. Left distal transradial access in the anatomical snuffbox for coronary angiography (ldTRA) and interventions (ldTRI). EuroIntervention. 2017; 13:851–857.