The use of intrastent peripheral stent in large coronary arteries: report of three cases

Feasibility and Efficacy of Herculink Elite ((TM)) Biliary Stent Implantation in Large Coronary Arteries (≥ 5 mm) and Venous Conduits: An Observational Study

BACKGROUND AND OBJECTIVES

Percutaneous coronary intervention (PCI) in patients with lesions of large calibre coronary arteries (≥ 5 mm) and saphenous venous grafts (≥ 5 mm) can be challenging. There are no separate guidelines available to treat these vessels with PCI. Standard coronary stents of 4 mm diameter are used to treat these lesions conventionally but carry the risk of under deployment, distortion of stent architecture and future stent thrombosis even if they are subsequently expanded beyond 5 mm.

METHODS AND RESULTS

Biliary stents (Herculink Elite™) provide a better alternative to standard coronary stents in these patients. These stents are of larger diameter (5-7 mm) and can be safely delivered over a 6 French sheath. In our case series, we demonstrate the use of intravascular ultrasound examination to confirm that biliary stents provide improved stent strut apposition within the coronary artery associated with extremely low repeat revascularisation rates.

CONCLUSION

Our paper highlights that PCI of lesions in patients with large calibre coronary arteries can successfully be achieved using biliary stents.

Two different successful angioplasty methods in patients with stenotic coronary artery ectasia

There is no current guideline for percutaneous coronary angioplasty in stenotic ectatic coronary arteries because of the heterogeneity of the coronary artery morphology. We report two successful angioplasty cases in coronary artery ectasia with different clinical scenarios. One case showed atherosclerotic stenosis in the ectatic portion of the right coronary artery that was aggravated after a coronary artery bypass graft. In this case, balloon angioplasty alone without stenting showed acceptable results at the 6-month follow-up coronary angiography. In the other case, we used a peripheral artery balloon and stent for stenosis in the ectatic portion of a large coronary artery. Six-month follow-up coronary angiography showed excellent patency of the previously implanted peripheral stent.

The use of tapered self-expanding stents and embolic protection devices in the treatment of stenotic ectatic coronary arteries: a report of two cases

OBJECTIVE

The usage of tapered self-expanding stents and embolic protection devices in the treatment of stenotic ectatic coronary arteries.

BACKGROUND

Coronary artery ectasia (CAE) is an uncommon disease that is occasionally found during cardiac catheterization. A high incidence of artherosclerotic disease is associated with CAE. Currently, there is no evidence-based approach for the management of stenotic ectatic coronary arteries (SEC).

METHODS

Percutaneous intervention with carotid stenting system and embolic protection system to recanalize SEC.

RESULTS

We describe two patients who presented with acute coronary syndrome and were found to have CAE with significant stenosis. Both patients underwent percutaneous intervention with RX ACCULINK Carotid stenting system and ACCUNET embolic protection system (Abbott Laboratories, Abbott Park, IL), successfully. This carotid stenting system is approved by FDA for stenting of extracranial carotid artery stenosis.

CONCLUSION

To the best of our knowledge, this is the first case report illustrating the usage of these devices as an alternative for the treatment of SEC.