title: Successful revascularization to right coronary artery by percutaneous coronary intervention after endovascular therapy for leriche syndrome.
abstract: A 69-year-old man with effort angina was admitted to our institution. Echocardiography showed poor left ventricular systolic function with akinesis of the anterior wall and severe hypokinesis of the inferior wall. We performed coronary angiography, which revealed two diseased vessels including chronic total occlusion in the left anterior descending artery and severe stenosis in the right coronary artery (RCA). In addition, aortography revealed aortoiliac occlusive disease known as Leriche syndrome. As the patient's symptom was stable, we first planned to perform endovascular therapy (EVT) for Leriche syndrome to make a route for intra-aortic balloon pumping. We prepared a bi-directional approach from bi-femoral arteries and a left brachial artery. The guidewire was passed through the occlusive area using the retrograde approach. The self-expanding stents were deployed by a kissing technique. At one week after EVT, a 6Fr sheath was inserted from the right radial artery and an intra-aortic balloon pump was successfully inserted through the right femoral artery for percutaneous coronary intervention (PCI) to the RCA. Two drug-eluting stents were successfully deployed to RCA after using an atherectomy device (rotablator). We reported the case as a successfully performed PCI to the RCA after EVT for Leriche syndrome.
authors.affiliation: Department of Cardiology, Okitama Public General Hospital, Yamagata, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Niizeki
authors.affiliation: Department of Cardiology, Nihonkai General Hospital, Yamagata, Japan.
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Kaneko
authors.affiliation: Department of Cardiology, Nihonkai General Hospital, Yamagata, Japan.
authors.forename: Shigeo
authors.initials: S
authors.lastname: Sugawara
authors.affiliation: Department of Cardiology, Okitama Public General Hospital, Yamagata, Japan.
authors.forename: Toshiki
authors.initials: T
authors.lastname: Sasaki
authors.affiliation: Department of Cardiology, Okitama Public General Hospital, Yamagata, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Tsunoda
authors.affiliation: Department of Cardiology and Hematology, Fukushima Medical University, Fukushima, Japan.
authors.forename: Yasuchika
authors.initials: Y
authors.lastname: Takeishi
authors.affiliation: First Department of Internal Medicine, Yamagata University School of Medicine, Yamagata, Japan.
authors.forename: Isao
authors.initials: I
authors.lastname: Kubota
keywords: Leriche syndrome; percutaneous coronary intervention; peripheral intervention