PMC6079505_01
Left coronary angiogram showing a moderate stenosis (arrow) of the left anterior descending coronary artery.
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The only angiographic abnormality noted was a moderate stenosis of the mid left anterior descending coronary artery (LAD) (Figure 1).
Occlusive dissection of the left main coronary artery.
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Angiography revealed only a stump of the left main coronary artery (LMCA) with occlusion of both the LAD and of the circumflex (LCx) coronary arteries (Figure 2).
Final deployment of the left anterior descending and left circumflex coronary artery stents with a kiss.
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Final deployment of the stents was with simultaneous inflation of the 2 balloons (kissing balloon dilation) (Figure 3).
Final angiographic result demonstrating patency of the left coronary system.
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Angiography demonstrated reestablishment of patency of the LM, LAD, and LCx (Figure 4), and intravascular ultrasound of the LAD and LM showed good stent apposition in these vessels.
Crossover balloon tamponade of the left femoral artery following removal of the Impella device.
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Because of the emergent need for Impella support in our patient, a technique of crossover balloon tamponade was used (Figure 5) with completion angiography to confirm hemostasis and absence of femoral artery abnormality or complication (Figure 6).
Final left femoral angiogram confirming hemostasis and absence of femoral artery abnormality or complication.
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Because of the emergent need for Impella support in our patient, a technique of crossover balloon tamponade was used (Figure 5) with completion angiography to confirm hemostasis and absence of femoral artery abnormality or complication (Figure 6).
Left coronary angiogram at 6-month follow-up showing continued patency of the previously placed stents.
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Follow-up coronary angiography 6 months after the initial procedure (Figure 7) showed continuing patency of the left coronary system without any significant residual stenosis.