PMC8606929_01
Coronary artery lesions. In (A) AP/caudal and (B) RAO/caudal views of proximal left anterior descending artery (LAD) with subtotal occluded lesion >95% (white arrow in each), distal vessel filling with homo and heterocollaterals. Angiography of the left circumflex (LCx) revealed mild diffuse disease, and patent first obtuse marginal (OM1) branch. In (C) is shown a LAO/caudal view of after successful percutaneous coronary infection (PCI) of proximal LAD lesion (black arrow) with TIMI III flow 2 weeks after (A) and (B) were obtained.
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He underwent a left heart catheterization, which revealed >95% stenosis in the proximal left anterior descending artery (Figure 1). With no bleeding during this antiplatelet "trial," he subsequently underwent a planned PCI where a successful 3.0 x 18 mm Xience Sierra (Abbott) DES was placed (Figure 1C).
Endoscopic bleeding lesions. On initial esophagoastroduodenoscopy 10 days after percutaneous coronary infection (PCI), vascular ectasias were identified in the duodenal bulb (A) and second portion of the duodenum (B). Yellow arrows point to ectasias. At the time of repeat esophagoastroduodenoscopy 2 weeks after initial endoscopy, evidence of mild portal hypertensive gastropathy was identified, along with a small non bleeding duodenal bulb vascular ectasia (center of the image; C) and a bleeding duodenal bulb vascular ectasia (D). The yellow arrow points to the edge of the bleeding lesion.
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Esophagogastroduodenoscopy the next day revealed nonbleeding gastric antral vascular ectasia, mild proximal gastropathy, and multiple angioectasias in the duodenum (Figure 2) treated with argon plasma coagulation.