Successful Isolation of a Huge Saccular Coronary Aneurysm by Combined Coil Embolization and Drug Eluting Stenting Presenter; Eun Jin Park Operator; Seung Woon Rha Cardiovascular Center Korea University Guro Hospital 1 st complex PCI 2016
Successful Isolation of a Huge Saccular Coronary Aneurysm by Combined Coil Embolization and Drug Eluting Stenting
Presenter; Eun Jin Park Operator; Seung Woon Rha
Cardiovascular Center
Korea University Guro Hospital
1st
complex PCI 2016
Patient’s Information
F/56
Chief complaint Referred for Lt. iliac a. stenting
Past Histroy HTN/DM/Hep/Tb/CKD (+/-/-/-/-)
Kawasaki Dz (-)
Lt carorid stenting (4MA)
A/S (-/-)
Familiy Hx (-/-)
Laboratory findings Routine lab & Cardiac enzyme; WNL
hsCRP, ESR; WNL
FANA/ANA (-/-), C3/C4 (-/-)
No evidence of systemic inflammation nor vasculitis
Baseline Coronary Angiogram
LCA, RAO cau, RCA, CTO, collateral from LCX (Gr.3)
EKG
Echocardiography
Seal the Rim of the CAA
Micro catheter tip (Finecross ,Terumo, Japan)
* Retrievable coil Interlock 3X12mm (Boston scientific, USA)
Packing remnant space of the CAA
Micro catheter tip
* Non-retrievable - coil Tornado 3X2mm (Cook, USA)
Wiring
Sion black (Asahi, Japan)
Finecross microcatheter (Terumo, Japan) Grandslam (Asahi, Japan)
DES positioniong at inlet of Aneurysm
Orsiro 3.0x18mm (Biotronik, Germany) Parallel wiring and stent delivery through soft wire
Final Angiogram
Coil embolization of CAA
Circ Cardiovasc Interv 2012;5:e3-e
Catheterization and Cardiovascular Interventions 79:1000–1003 (2012)
* Micro catheter entrapping with stent deploying
Conclusion
Huge saccular coronary aneurysm companied by severe stenosis
1. Seal the rim of the aneurysm
with Retrievable coil
2. Packing the remnant space
with non-retrievable coil
3. Wiring to the distal vessel
beside the aneurysm
4. DES implantation along with
soft wire following parallel
wiring