Author + information
- Received June 7, 2016
- Revision received June 10, 2016
- Accepted June 20, 2016
- Published online September 26, 2016.
- aDepartment of Cardiology, Tokyo Bay Urayasu Ichikawa Medical Center, Chiba, Japan
- bDepartment of Cardiovascular Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, Chiba, Japan
- ↵∗Reprint requests and correspondence:
Dr. Kotaro Obunai, Department of Cardiology, Tokyo Bay Urayasu Ichikawa Medical Center, 3-4-32, Todaijima, Urayasu, Chiba 279-0001, Japan.
A 73-year-old man underwent ascending and total arch replacement for thoracic aortic aneurysm. Seven days after the surgery, he developed acute coronary syndrome with ST-segment elevation in the aVR and aVL leads, and diffuse ST-segment depression in all other leads (Figure 1). Emergent coronary angiography revealed a large radiolucent filling defect in the left main coronary artery (Figure 2A, Online Video 1). Aspiration thrombectomy with a 7-F aspiration catheter was attempted initially, but was unsuccessful, leading migration of the filling defect further into the left circumflex artery. The 2.5 × 15 mm coronary angioplasty balloon was then inflated distal to the filling defect and pulled into the deeply seated 8-F guiding catheter with the balloon kept inflated (Figure 2B, Online Video 2). The Y-connector was removed from the guiding catheter and the balloon catheter was pulled out from the guiding catheter, together with a large atherosclerotic plaque (Figure 2C). Final angiogram showed distal embolization of the left anterior descending artery, but the filling defect disappeared (Figure 2D, Online Video 3).
We experienced a case of successful retrieval of the atherosclerotic plaque in the left main coronary artery with Fogarty-like thrombectomy technique using coronary balloon catheter. Our case illustrated that retrieval of the atherosclerotic plaque can be performed safely and effectively with a simple device and technique routinely used in the cath lab.
For supplemental videos, please see the online version of this article.
All authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received June 7, 2016.
- Revision received June 10, 2016.
- Accepted June 20, 2016.
- American College of Cardiology Foundation