title: Intravascular ultrasound-guided percutaneous coronary intervention for total occlusion of the proximal left anterior descending artery caused by spontaneous coronary dissection in a young woman.
abstract: A 35-year-old woman was admitted to our hospital because of a sudden cardiac arrest caused by an acute anterior myocardial infarction. Emergency coronary angiography showed total occlusion of the proximal left anterior descending artery (LAD). We performed an intravascular ultrasound (IVUS) to detect the LAD orifice and successfully inserted the guidewire to the occluded LAD. An IVUS revealed coronary dissection and no atheromatous plaque from the orifice to the mid-portion of the LAD and the guidewire was in the true lumen. Two bare metal stents were implanted in the proximal and mid portion of the LAD. After stenting to the LAD, coronary dissection retrogradely extended to the left circumflex artery (LCx). Therefore, we performed additional stent implantation from the left main trunk (LMT) to the proximal LCx and the just proximal LAD. An IVUS guided percutaneous coronary intervention (PCI) enabled complete revascularization to spontaneous coronary artery dissection.
authors.affiliation: Department of Cardiology, Komaki City Hospital, 1-20 Jobushi, Komaki, Aichi, 485-8520, Japan, nao1109komaki@yahoo.co.jp.
authors.forename: Naoaki
authors.initials: N
authors.lastname: Kano
authors.affiliation: Department of Cardiology, Komaki City Hospital, 1-20 Jobushi, Komaki, Aichi, 485-8520, Japan, nao1109komaki@yahoo.co.jp.
authors.forename: Naoki
authors.initials: N
authors.lastname: Kano
authors.forename: Katsuhiro
authors.initials: K
authors.lastname: Kawaguchi
authors.forename: Junya
authors.initials: J
authors.lastname: Funabiki
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Kamimura
authors.forename: Akinori
authors.initials: A
authors.lastname: Sawamura
authors.forename: Kentaro
authors.initials: K
authors.lastname: Mukai
authors.forename: Hajime
authors.initials: H
authors.lastname: Imai
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Ogawa
authors.forename: Taizo
authors.initials: T
authors.lastname: Kondo
mesh_terms: D000328:Adult; D000784:Aortic Dissection / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation / Q000379:methods*; D056988:Anterior Wall Myocardial Infarction / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D003323:Coronary Aneurysm / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D017023:Coronary Angiography / Q000379:methods; D023921:Coronary Stenosis / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D016757:Death, Sudden, Cardiac / Q000209:etiology; D004562:Electrocardiography / Q000379:methods; D004638:Emergency Treatment; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D035583:Rare Diseases; D018570:Risk Assessment; D012720:Severity of Illness Index; D013997:Time Factors; D018084:Ultrasonography, Interventional