Behandlung eines koronaren pseudoaneurysmas durch stent-graft- implantation

Translated title of the contribution: Treatment of a coronary pseudoaneurysm by stent-graft implantation

C. von Birgelen, M. Haude, F. Liu, J. Ce, G. Görge, D. Welge, H. Wieneke, D. Baumgart, D. Opherk, R. Erbel

Research output: Contribution to journalArticleAcademicpeer-review

15 Citations (Scopus)

Abstract

History and clinical findings: A 54-year-old man was urgently admitted because of sudden onset of progressively worsening angina pectoris, his first attack. Physical examination was unremarkable. Investigations: Electrocardiography and laboratory tests excluded acute myocardial infarction. With the exception of hypercholesterolemia (toal cholesterol 247 mg/dl) laboratory tests were normal. Coronary angiography revealed a 60% eccentric narrowing in the proximal part of the interventricular branch with adjacent aneurysmatic dilatation. Intravascular ultrasound (IVUS) showed a coronary pseudoaneurysm, its cavity communicating with the empty atheroma hole of an adjacent ruptured coronary plaque. Treatment and course: A 19 mm stent graft was implanted, via a percutaneously inserted balloon-catheter system, in the region of the stenosis and the pseudoaneurysm. Subsequent angiography demonstrated a smooth nonstenotic lumen. The membrane of the graft (made of polytetrafluoroethylene [PTFE]), fixed between two thin metal stents, had occluded the pseudoaneurysm. Occlusion of an immediately distal septal branch briefly produced an asymptomatic rise of creatine kinase to maximaly 173 U/l. Oral medication included ticlopidine hydrochloride (2 x 250 mg daily for 4 weeks). The patient was symptom-free after the procedure and was discharged 5 days later. Conclusion: Implantation of a new type of stent- graft provides quick and uncomplicated treatment of a coronary aneurysm. The membrane fixed between two stents prevents wash out of any thrombi. The method may also be applicable to other potentially thrombus-containing lesions.

Translated title of the contributionTreatment of a coronary pseudoaneurysm by stent-graft implantation
Original languageGerman
Pages (from-to)418-422
Number of pages5
JournalDeutsche Medizinische Wochenschrift
Volume123
Issue number14
DOIs
Publication statusPublished - 3 Apr 1998
Externally publishedYes

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