Support Comes From Many Directions
A 65-year-old male presented with angina pectoris. Five months prior to this procedure, attempted recanalization of his right coronary artery was performed unsuccessfully. He presented with recurrent angina. His risk factors included hyperlipidemia and diabetes mellitus. He also had a previous PTCA of the ramus in 2008. The patient’s right coronary artery showed ipsilateral collaterals and a right radial approach was attempted. We did not place a contralateral catheter.
Carotid Long Lesions: Think Outside the Box
A 69-year-old male patient presented with asymptomatic carotid artery stenosis. The patient is considered high-risk because of non-revascularizable coronary disease and bilateral carotid disease. He had undergone previous left carotid endarterectomy and had a new right internal carotid artery stenosis by both carotid Doppler and CTA of 90%. The patient was enrolled in the Abbott CHOICE high-risk protocol.
Bifurcation PCI -- KISS
A 52-year-old diabetic male presented with unstable angina. His risk factors included type II diabetes mellitus, hyperlipidemia, and tobacco use. He had undergone previous coronary bypass and had a patent mammary bypass and right coronary artery saphenous vein bypass. Previous Myoview stress test showed a large amount of lateral ischemia with maintained LV function (ejection fraction 63%).
Suck-U-Surge Via the Radial Route
A 60-year-old gentleman presented with angina and a mild reversible defect in the lateral and infralateral segment. The patient underwent coronary bypass 25 years ago and had a previous patent internal mammary vessel with 100% occlusion of the right coronary with a patent graft to the ramus and internal mammary to the lower anterior descending artery (LAD). He presented with mild angina. The angiogram shows the internal mammary to be patent.
A Morbidly Obese Acute Coronary Syndrome Patient Presents with 3-Vessel Coronary Disease: How Do You Treat?
A 65-year-old gentleman presented to us with severe substernal chest pain within an hour of gastric bypass surgery. The patient’s risk factors include morbid obesity, hypertension, hyperlipidemia and positive family history of heart disease. The patient is 5’9” and 330 pounds. His EKG shows nonspecific ST and T wave changes. At the time of presentation, his enzymes were not back, and there were no acute changes on his electrocardiogram. His troponins were positive and this was treated as a non-ST elevation myocardial infarction.
Suck-U-Surge Revisited
Clinical History
A 78-year-old male with no known coronary disease presented with worsening 
congestive heart failure symptoms. He previously had bypass surgery. His presentation revealed his saphenous vein graft to the circumflex was widely patent a year before. He presented with angina and inferior lateral ischemia. A diagnostic study was performed. His right coronary artery was stented at 2 focal areas, and he was brought back for intervention 3 days later. We did both the initial procedure as well as the follow up procedure via the right radial artery.
A Case Using the Proteus™ Embolic Protection Balloon
The U.S. Food and Drug Administration has approved the Proteus™ balloon
(Angioslide, Inc., Minneapolis, Minnesota) for peripheral transluminal angioplasty (PTA) and for capture and containment of embolic material during angioplasty in the lower extremities. Initially, the device functions as a normal angioplasty balloon; the balloon is semicompliant and is inflated to a nominal pressure of 8 atmospheres (atm).
Outback Downtown: A Case of Critical Limb Ischemia
An 87-year-old gentleman presented with critical limb ischemia of the left leg. He had been followed at the Wound Care Center and had a left big toe non-healing ulcer of several centimeters’ diameter. It was so painful that the patient literally stated he wanted to have his leg cut off.
