Congenital Absence of Left Circumflex Coronary Artery

Congenital absence of left circumflex artery is a rare congenitalanomaly of the coronary arteries. The prevalence of theanomaly in different studies ranges from 0.6% to 1.3%. Ofthese, 80% are benign and asymptomatic and 20% are clinicallyimportant. We report a 56-year-old man presented withacute resting chest pain who was diagnosed as having acuteanterolateral infarction accompanied by electrocardiographicchanges and elevated cardiac enzymes. Coronary angiographyin different views was conducted, however, no left circumflexartery was found. The territory supplied by the artery had beenperfused by the super dominant right coronary artery. Therewas no left circumflex coronary artery with anomalous origin.Sever stenosis of left anterior ascending artery superimposedto the absent left circumflex artery was presented as acute anterolateralinfarction. Although absence of the artery is mostlyconsidered as a benign condition, atherosclerotic lesions maybe more important in such cases because of diminished compensatingmechanisms

Management of Iatrogenic Rupture of Profunda Femoris Artery after Femoral Fracture Fixation with Stent Graft Implantation

Vascular injuries with acute or chronic arterial hemorrhage after femoral shaft fractures are a rare but a life-threateningcomplication. We observed a case of iatrogenic rupture of the profunda femoris artery after the internal fixation of a femoralshaft fracture. The pseudoaneurysm, presenting with painful expansile swelling and hemodynamic instability, together withthe rupture was evident on femoral angiography. Endovascular stent graft placement was performed successfully, and there was no sign or symptom at 9 months’ follow-up

The relationship between severity of coronary artery disease and mean platelet volume

Aims Increased MPV is a risk factor for cardiovascular diseases and can be associated with coronary artery involvement. In this study, we aimed to investigate the relationship between the severity of coronary artery disease and MPV. Materials and methods In this study, a total of 200 patients with coronary artery disease were enrolled. All patients initially underwent coronary angiography. Plasma TG, LDL, and HDL, was measured using commercial kits Integra 800TM. MPV and platelet count was determined by the Sysmex XT-2000iTM. Population were divided into three groups based on the SYNTAX score: low, moderate and high. All angiographic grading of SYNTAX was carried out by two cardiologists with blinded clinical data. After Data collection, these data were entered to SPSS22 software and were analyzed using correlation coefficient regression analysis. Results A total of 200 patients entered to the study that 43% and 57 % of patients were female and male, respectively. eighty-seven patients were diabetic and other 113 patients were not diabetic. There was a significant correlation between SYNTAX score and the BMI, hemoglobin, LDL, FBS, EF and particularly MPV. There was no significant correlation between SYNTAX score and systolic and diastolic blood pressure, HDL, triglycerides, WBC and glomerular filtration rate. Conclusion The results of this study showed that because of significant correlation between MPV and SYNTAX score, this variable can be used as an indicator of the severity of coronary artery disease

Trans-Catheter Therapy of Lutembacher Syndrome: A Case Report

Lutembacher syndrome refers to the rare combination of a congenital atrial septal defect and acquired mitral stenosis. Traditionally, Lutembacher syndrome has been corrected by surgical treatment. We describe two patients treated percutaneouly with a combined Inoue balloon valvuloplasty and septal defect closure using the Amplatzer septal occlusion device

Endovascular Treatment of Post-Traumatic Pseudoaneurysms of Ulnar and Radial Artery

Aneurysm can develop in all arteries of the human body. Pseudoaneurysm induced by trauma is known as a rare condition in peripheral arteries. This complication is known as late sequelae of trauma. The incidence of pseudoaneurysm in upper extremities artery is less than lower extremities. Atherosclerotic aneurysms are often seen in large arteries and by aging, but pseudoaneurysm can be seen in penetrating or blunt trauma in patients of every age or every location. Delayed treatment of pseudoaneurysm leads to bleeding, venous edema at the extremities and compression on the adjacent nerve as a result of pseudoaneurysm enlargement. Early diagnosis of pseudoaneurysm is very important, because this complication can induce disabilities such as upper extremities and finger loss. Peripheral arteries pseudoaneurysm in distal locations especially in brachial artery and forearm can cause a thrombotic complication in hands and fingers

Effect of slow coronary flow on signal-averaged electrocardiogram

The slow flow coronary or decreased coronary TIMI flow rate is characterized by delayed pacification of coronary vessels in the absence of any evidence of obstruction coronary artery disease and is detected by coronary angiography. In the present study, we aimed to evaluate the effects of slow coronary artery flow on signal-averaged electrocardiogram (SAECG) as a possible indicator of increased risk for ventricular arrhythmias and sudden cardiac death. Methods The study included 43 patients with angiographically proven normal coronary arteries and slow coronary flow (mean age = 53.7 ± 8.3 years), and 43 patients with angiographically proven normal coronary arteries without associated slow coronary flow (mean age = 52.8 ± 8.5 years). Coronary flow rates of all subjects were documented by thrombolysis in myocardial infarction frame count (TIMI frame count). SAECG was performed for each subject and late potentials were measured. Results There was no statistically significant difference between the two groups in respect to age, gender, presence of hypertension, diabetes mellitus, opium addiction, cigarette smoking, typical angina, and positive exercise, blood sugar, white blood cell count and platelet count. There was a significant difference between the two groups in respect to the lipid profiles, uric acid level, body mass index, hemoglobin and positive CRP (P < 0.05). Abnormal SAECG was more frequent in SCF compared to control subjects (P=0.003). Conclusion Abnormal SAECG and late potentials, indicating increased risk for ventricular arrhythmias and cardiovascular mortality was found to be significantly higher in patients with slow coronary artery flow

Coincidence of renal artery stenosis and coronary artery stenosis

Aims The aim of this study was to investigate the prevalence of renal artery stenosis in patients with severe coronary artery disease or stenosis of the left main coronary artery. Materials and methods This cross-sectional study was performed on 264 patients with a history of severe hypertension who were candidates for coronary artery angiography in Yazd Afshar Hospital. During coronary angiography, renal angiography was performed on all of the patients. At the same time, we investigated the renal artery stenosis and its association with a history of diabetes mellitus, high body mass index (BMI), hyperlipidemia, and other cardiovascular risk factors. Renal artery stenosis was defined based on luminal narrowing: mild (50%), moderate (75%), and severe (75%) decrease in luminal diameter. Collected data were analyzed by SPSS software (version 18.0). Results Among 264 patients, 54.92% were males and 45.08 % were females with the average age of 58.0±8.6. 83.71% of the patients had coronary artery disease and included 52.94% hyperglycemic, 63.39% diabetic, and 29.86% smokers. Prevalence of the renal artery stenosis (equal to or more than 50%) was 38.25% in all patients, including 43.56% in men and 56.44%, in women, which shows a significant difference (P=0.04). Prevalence of co-morbidity of coronary artery disease and renal artery stenosis for 1-vessel, 2-vessels, and 3-vessels disease was 34%, 57.14%, and 54.17%, respectively, that showed a significant difference (P<0.01). Conclusion Our findings showed a high prevalence (38.25%) of renal artery stenosis in hypertensive patients with coronary artery diseases. Accordingly, we suggest that simultaneous renal angiography after coronary angiography in hypertensive patients may help to find patients with renal artery stenosis and subsequently better management of these patients

Ascorbic acid effect on CIN incidence in diabetic patient after coronary angiography

Background: This study aims to investigate the antioxidant effect of vitamin C in preventing contrast-induced nephropathy (CIN) in diabetic patients after catheterization. Materials and Methods: In a double blinded, randomized controlled trial, 90 diabetic patients who were referred for cardiac catheterization were randomly allocated into two arms of vitamin C (A) and placebo (B). The treatment arm (A) received 2 g of vitamin C orally 2 h before catheterization and the control group (B) received 2 g of oral placebo. Six hours before catheterization, patients received fluid resuscitation with normal saline (CIN was considered as a 25% rise in creatinine (Cr) level or an increase of 0.5 mg/dL in earlier creatinine). CIN was compared between groups. Before andthree days after catheterization. Serum Bun – Cr was measured and GFR were calculated. The results were compared between the two groups. Six hours before catheterization, patients received fluid resuscitation with normal saline CIN was compare between arms. Results: Mean GFR in group (A) before procedure was respectively 69.82±19.26 and after the treatment was 81.51±27.40 (P=0.001). But in group (B) it was 74.18±24.41 and 75.20±29.65 (P=0.747). Contrast-induced nephropathy was observed in 10 patients (12.3%) including 3 patients (7.7%) in group (A) and (16.7%, 7 patients) in group (B) (P=0.315). Conclusion: Ascorbic acid intake in diabetic patients prior to use of contrast agents can be effective in maintaining GFR, but the incidence of contrast-induced nephropathy is not associated with the consumption of ascorbic acid