Staged Percutaneous Coronary Intervention with Rotational Atherectomy or Bypass Surgery in Chronic Hemodialysis and Severely Calcified Left Main True Bifurcation Lesion: A Case Report and Literature Review

Previous observational studies and meta-analyses reported that the optimal strategy of coronary revascularization (percutaneous coronary intervention [PCI] and bypass surgery) for anatomically complex coronary artery lesions in the chronic hemodialysis setting is still controversial because the long...

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Bibliographic Details
Published inClinical Medicine Insights. Cardiology Vol. 14; p. 1179546820951798
Main Authors Dan, Kazuhiro, Shinoda, Akira, Garcia-Garcia, Hector M
Format Journal Article
LanguageEnglish
Published London, England SAGE Publications 2020
Sage Publications Ltd
SAGE Publishing
Subjects
Angioplasty
Calcification
Case Report
Case reports
Coronary vessels
Heart surgery
Hemodialysis
Kidney diseases
Stents
left main trunk
end-stage renal disease
Bifurcation stenting
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Summary:Previous observational studies and meta-analyses reported that the optimal strategy of coronary revascularization (percutaneous coronary intervention [PCI] and bypass surgery) for anatomically complex coronary artery lesions in the chronic hemodialysis setting is still controversial because the long-term outcomes were superior with coronary artery bypass grafting, especially with regard to repeat revascularization; however, short-term mortality with PCI was significantly lower because it is less invasive. Moreover, no guidelines show a strategy for this setting. We report the case of a patient with chronic dialysis and calcified left main true bifurcation lesion who underwent staged PCI with rotational atherectomy and minimally invasive direct coronary artery bypass for in-stent restenosis who died of non-occlusive mesenteric ischemia.
Bibliography:ObjectType-Case Study-2
SourceType-Scholarly Journals-1
content type line 23
ObjectType-Report-1
ISSN:1179-5468
1179-5468
DOI:10.1177/1179546820951798