Iatrogenic left anterior descending artery stenosis in response to the nose cone of a directional atherectomy device: a different sort of restenosis.
Restenosis after percutaneous transluminal coronary angioplasty (PTCA) is well described and refers to the development of a significant narrowing at the site of the lesion treated. A case is reported of a female patient who underwent directional coronary atherectomy (DCA) and stent insertion at the origin of the left anterior descending artery. This was performed without complication. Repeat angiography was performed because of return of angina after ten weeks; it demonstrated a widely patent stent, but also a significant stenosis distal to the stent where the nose cone of the DCA device had been positioned. This stenosis was successfully stented. The patient remains well at follow-up.
Holt
N D
ND
Department of Cardiology, South Cleveland Hospital, Middlesbrough, Cleveland TS4 3BW, United Kingdom.
de Belder MA
D017225:Atherectomy, Coronary / Q000009:adverse effects* / Q000295:instrumentation*; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000628:therapy*; D023903:Coronary Restenosis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D004864:Equipment and Supplies / Q000009:adverse effects; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D008875:Middle Aged; D019233:Retreatment