PMC5903018_01
(A-C) Percutaneous coronary intervention (PCI) for the stenosis in the left anterior descending coronary artery (LAD). (A) There was a significant stenosis in the mid portion of the LAD (white arrow). (B) PCI was performed by deploying a drug-eluting stent. (C) After successful stent deployment, coronary angiography showed a good result. (D-F) Angiography of the right superficial femoral artery (SFA) before and after endovascular therapy (EVT) procedure. (D) Initial angiography showed total occlusion of the distal portion of the right SFA (dotted line). (E) EVT was performed with PTA balloon inflation. (F) Final angiography showed a good result.
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After admission, coronary angiogram through left RA access showed severe stenosis at the mid-LAD (Segment 7) (Fig. 3A). TREK  3.0 x 15 mm balloon (Abbott Vascular, Abbott Park, IL, USA) was inserted to dilate the lesion in the LAD, and then a 3.0 x 24 mm Nobori stent (Terumo CO., Ltd., Tokyo, Japan) was implanted at 12 atmospheres (Fig. 3B). The final angiographic result showed successful dilation of the lesion (Fig. 3C). The initial angiography showed the peripheral chronic total occlusion (CTO) in the right distal SFA (Fig. 3D). After removal of a Trytop Longbow   balloon (DVx), we exchanged the balloon for a 6 x 40 mm Trytop Longbow  balloon (shaft length: 170 cm, DVx) and dilated the lesion (Fig. 3E). A final angiography showed an excellent result (Fig. 3F).
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Maximum intensity projection image of computed tomographic angiography (CTA). CTA showed the PTA stents implanted in the right and left superficial femoral artery, and the patency of both leg arteries was confirmed.
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AZ, USA). After one year from the EVT, CT angiogram of the legs showed good vessel patency (Fig. 4), and ABI was 1.11 in right leg; 1.00 in left leg, respectively.
Angiography of the right and left superficial femoral artery (SFA) before and after endovascular therapy (EVT) procedure. (A) Initial angiography showed the in-stent total occlusion of the right SFA from its ostium (right), the occlusion of the left common femoral artery (CFA) and the in-stent total occlusion of the left SFA (left). (B) EVT was performed with PTA balloon inflation in both SFA and left CFA. c Final angiography showed good vessel patency of both SFA.
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SFA from its ostium, the occlusion of the left common femoral artery (CFA), and the in-stent occlusion of the left SFA (Fig. 5A). Subsequently, EVT for these lesions in both legs was started by placing a 6 Fr Glidesheath Slender  introducer sheath (Terumo) in the left RA. After balloon dilatation with several overlapping inflations (Fig. 5B; right), the angiography showed good vessel patency (Fig. 5C; right). After the placement of the guiding sheath in the left external iliac artery, a 0.018 inch Gaia  PV wire (Asahi Intec) was crossed into the lesions and a 6 x 40 mm Trytop Longbow  balloon (DVx) was dilated (Fig. 5B; left). The final angiography showed good vessel patency (Fig. 5C; left).