Preview

Innovative Medicine of Kuban

Advanced search

SUCCESSFUL ENDOVASCULAR TREATMENT FOR LCA TRUNK TRIFURCATION LESION

Abstract

Left coronary artery (LCA) supplies blood to 75100% of myocardial volume of the left ventricle (LV). The atherosclerotic lesion of LCA trunk causes an ischemia in the sufficient area of the myocardium that often results in LV dysfunction, heart failure, and arrhythmia. The risk of death in cases with this pathology reaches 50% at drug treatment. Several decades, coronary artery bypass graft surgery (CABG) was considered as "the golden standard" of treatment for LCA trunk stenosis. Due to the skills and experience in treatment for coronary pathology, new technologies development and stenting techniques, percutaneous transluminal coronary angioplasty (PTCA) for LCA trunk stenosis became more effective and safe treatment. Despite this, trifurcation of LCA trunk remains extremely difficult pathology for endovascular treatment, for a lack of sufficient experience. In the present paper we described successful endovascular treatment for trifurcation lesion of LCA trunk in a case with acute coronary syndrome (ACS).

About the Authors

A. S. Nekrasov
Scientific Research Institute – Ochapovsky Regional Clinical Hospital no. 1, The Krasnodar Krai Ministry of Health
Russian Federation


A. A. Grechishkin
Scientific Research Institute – Ochapovsky Regional Clinical Hospital no. 1, The Krasnodar Krai Ministry of Health
Russian Federation


S. V. Mayngart
Scientific Research Institute – Ochapovsky Regional Clinical Hospital no. 1, The Krasnodar Krai Ministry of Health
Russian Federation


References

1. Stone P., Goldschlager N. Left main coronary artery disease: review and appraisal. Cardiovasc Med 1979; 4: 165 - 177. Taylor H, Deumite N., Chaitman B., Davis K., Killip J., Rogers W. Asymptomatic left main coronary artery disease in the Coronary Artery Surgery Study (CASS) registry. Circulation 1989; 79: 1171 - 1179.

2. Kini S., Bis K.G., Weaver L. Normal and variant coronary arterial and venous anatomy on high resolution CT angiography. AJR Am J Roentgenol. 2007; 188 (6): 1665-74. doi: 10.2214/AJR.06.1295 - Pubmed citation.

3. Koşar P., Ergun E., Oztürk C. et-al. Anatomic variations and anomalies of the coronary arteries: 64-slice CT angiographic appearance. Diagn Interv Radiol. 2009; 15 (4): 275-83. doi: 10.4261/1305-3825.DIR.2550-09.1 -Pubmed citation.

4. Anselmino M., Biondi-Zoccai G., Moretti C., Sheiban I. Percutaneous coronary intervention on left main coronary artery trifurcation. Heart Vessels 2008; 23: 279 - 281.

5. Colombo A., Moses J.W., Morice M.C., et al. Randomized study to evaluate sirolimus-eluting stents implanted at coronary bifurcation lesions. Circulation 2004; 109: 1244 - 1249.

6. Park S.-J., Park S.-W. Treated with Cross-over Technique Using Drug-Eluting Stents. Представлено на сайте TCTMD.com, 2007.

7. Shammas N.W., Dippel E.J., Avila A. Long-term outcomes in treating left main trifurcation coronary artery disease with the Paclitaxel-eluting stent. J Invasive Cardiol 2007; 19(2): 77 - 82.

8. Shammas N.W., Shammas G.A., Jerin M., et al. Treatment of Left Main Coronary Trifurcation Lesions with the Paclitaxel Drug-Eluting Stent: Mid-Term Outcomes from a Tertiary Medical Center. J Invasive Cardiol 2009; 21: 321 - 325.

9. Рекомендации ESC/EACTS по реваскуляризации миокарда 2014.

10. ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery: Executive Summary 2011.

11. Buszman, P.E., Kiesz, S.R. and Bochenek, A. (2008) Acute and Late Outcomes of Unprotected Left Main Stenting in Comparison with Surgical Revascularization. Journal of the American College of Cardiology, 51, 538 - 545.

12. Chen, S.L., Zhang, J.J., Ye, F., et al. (2008) Study Comparing the Double Kissing (DK) Crush with Classical Crush for the Treatment of Coronary Bifurcation Lesions: The DKCRUSH-1 Bifurcation Study with Drug-Eluting Stents. European Journal of Clinical Investigation, 38, 361- 371.


Review

For citations:


Nekrasov A.S., Grechishkin A.A., Mayngart S.V. SUCCESSFUL ENDOVASCULAR TREATMENT FOR LCA TRUNK TRIFURCATION LESION. Innovative Medicine of Kuban. 2017;6(2):21-26. (In Russ.)

Views: 810


ISSN 2541-9897 (Online)