Percutaneous revascularization of chronic total occlusion of left anterior descending artery using contralateral injection via isolated conus artery.
A 74-year-old male underwent cardiac catheterization that revealed a chronic total occlusion of the proximal left anterior descending coronary artery (LAD). The right coronary artery provided only faint collateral circulation to the LAD. Multislice computed tomography (MDCT) disclosed that a conus artery took off directly from the aorta and provided good collateral circulation to the LAD. Percutaneous coronary intervention of the LAD was successfully performed using contralateral injection via the isolated conus artery. Whenever sufficient collateral filling is not visualized in a chronically occluded LAD, an isolated conus artery should be considered. MDCT is a helpful tool in this setting.
Division of Cardiology, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan. kawamura@cpnet.med.keio.ac.jp
Akio
A
Kawamura
Masahiro
M
Jinzaki
Sachio
S
Kuribayashi
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation / Q000379:methods*; D006328:Cardiac Catheterization; D003097:Collateral Circulation / Q000502:physiology*; D003287:Contrast Media / Q000008:administration & dosage; D017023:Coronary Angiography / Q000379:methods*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging* / Q000628:therapy*; D054855:Drug-Eluting Stents; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D008297:Male; D020123:Sirolimus / Q000008:administration & dosage; D036542:Tomography, Spiral Computed / Q000379:methods*
D003287:Contrast Media; D007166:Immunosuppressive Agents; D020123:Sirolimus