Successful Isolation of a Huge Saccular Coronary Aneurysm by Combined Coil Embolization and Drug Eluting Stenting

Presenter; Eun Jin Park Operator; Seung Woon Rha

Cardiovascular Center

Korea University Guro Hospital

1st

complex PCI 2016

Patient’s Information

F/56

Chief complaint Referred for Lt. iliac a. stenting

Past Histroy HTN/DM/Hep/Tb/CKD (+/-/-/-/-)

Kawasaki Dz (-)

Lt carorid stenting (4MA)

A/S (-/-)

Familiy Hx (-/-)

Laboratory findings Routine lab & Cardiac enzyme; WNL

hsCRP, ESR; WNL

FANA/ANA (-/-), C3/C4 (-/-)

No evidence of systemic inflammation nor vasculitis

Baseline Coronary Angiogram

LCA, RAO cau, RCA, CTO, collateral from LCX (Gr.3)

EKG

Echocardiography

Seal the Rim of the CAA

Micro catheter tip (Finecross ,Terumo, Japan)

* Retrievable coil Interlock 3X12mm (Boston scientific, USA)

Packing remnant space of the CAA

Micro catheter tip

* Non-retrievable - coil Tornado 3X2mm (Cook, USA)

Wiring

Sion black (Asahi, Japan)

Finecross microcatheter (Terumo, Japan) Grandslam (Asahi, Japan)

DES positioniong at inlet of Aneurysm

Orsiro 3.0x18mm (Biotronik, Germany) Parallel wiring and stent delivery through soft wire

Final Angiogram

Coil embolization of CAA

Circ Cardiovasc Interv 2012;5:e3-e

Catheterization and Cardiovascular Interventions 79:1000–1003 (2012)

* Micro catheter entrapping with stent deploying

Conclusion

Huge saccular coronary aneurysm companied by severe stenosis

1. Seal the rim of the aneurysm

with Retrievable coil

2. Packing the remnant space

with non-retrievable coil

3. Wiring to the distal vessel

beside the aneurysm

4. DES implantation along with

soft wire following parallel

wiring