Garg, Scot

Kim, Moo Hyun

Shin, Eun-Seok

Yuan, Song Lin

English

Via Medica Journals

Address for correspondence: Eun-Seok Shin, MD, PhD, Division of Cardiology, Department of Internal Medicine, Ulsan Medical Center, Ulsan, South Korea, e-mail: sesim1989@gmail.comReceived: 3.04.2020 Accepted: 13.04.2020A case of drug-coated balloon treatment  for two total occluded lesions in a patient  with acute coronary syndromeSong Lin Yuan1, 2, Moo Hyun Kim2, Scot Garg3, Eun-Seok Shin11Division of Cardiology, Department of Internal Medicine, Ulsan Medical Center, Ulsan, South Korea 2Department of Cardiology, Dong-A University Hospital, Busan, South Korea 3East Lancashire Hospitals NHS Trust, Blackburn, Lancashire, United KingdomA 51-year-old man was admitted with worsen-ing effort angina over a 1 month period. His only coronary risk factor was hypercholesterolemia. Cardiac enzymes including creatine kinase-MB and troponin I were normal. His electrocardio-gram showed Q-waves in V1 to V4. The coronary angiograms showed a short left main with com-plete occlusions in the proximal left anterior de-scending (LAD) and left circumflex (LCX) artery (Fig. 1A–C). Revascularization options were dis-cussed and the option to treat the lesions with drug-coated balloons (DCB) was decided. He was carefully assessed, and gave informed consent.A guide wire successfully crossed the total oc-clusion of the LCX. Pre-dilatation was performed with a 1.5 × 15 mm balloon, followed by a 2.5 × × 15 mm non-compliant balloon up to 16 atm and finally a 2.5 × 30 mm DCB was inflated at 7 atm for 60 s. Then to the LAD lesion, pre-dilatation was performed with 1.5 × 15 mm balloon and a 3.0 × × 15 mm scoring balloon at 16 atm, and then finally a 3.5 × 20 mm DCB was inflated at 7 atm for 60 s. The final angiograms showed normal flow in both LAD and LCX with no significant dissection or residual stenoses (Fig. 1D–F).Three months later, follow-up coronary angio-graphy confirmed adequate patency of the DCB treated lesions and reassuringly the distal LCX and proximal LAD looked better (Fig. 1G–I). He re-mains symptom free, 13-month post-intervention.After treatment with a DCB, it is possible that vessels will return to their original size over time, which is one of the greatest advantages of DCB treatment in total occluded lesions.Conflict of interest: None declaredINTERVENTIONAL CARDIOLOGYCardiology Journal 2020, Vol. 27, No. 3, 320–321DOI: 10.5603/CJ.2020.0083 Copyright © 2020 Via MedicaISSN 1897–5593320 www.cardiologyjournal.orgIMAGE IN CARDIOVASCULAR MEDICINEFigure 1. Coronary artery angiography; A–C. Before intervention; D–F. Right after treatment with a drug-coated balloon; G–I. Follow-up angiography at 3 months.A B CD E FG H Iwww.cardiologyjournal.org 321Song Lin Yuan et al., Drug-coated balloon treatment for total occlusion

A case of drug-coated balloon treatment for two total occluded lesions in a patient with acute coronary syndrome

https://journals.viamedica.pl/cardiology_journal/article/download/CJ.2020.0083/51190

A case of drug-coated balloon treatment for two total occluded lesions in a patient with acute coronary syndrome

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