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Percutaneous sealing of coronary aneurysm by grafted stent implantation
  1. M K Erol,
  2. E Bozkurt,
  3. S Arslan

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A 72 year old man was admitted to our clinic because of recurrent angina pectoris on the 20th day of an acute anterior myocardial infarction. He had been treated with metoprolol, quinapril, isosorbide mononitrate, aspirin, and simvastatin. Coronary angiography revealed two stenotic lesions in the mid portion of left anterior descending artery. The first lesion was about 80%, the second was about 60%, and there was a coronary aneurysm in between the lesions (upper panels). Placement of a direct grafted stent was decided upon. After passing the lesions with a 0.014 inch guide wire, a 3.0–16 mm grafted stent (Jostent coronary stent graft) was advanced over the wire to cover the two lesions and the aneurysm, and was expanded. Final angiography showed no residual stenosis and no more contrast flow into the aneurysm (lower panels). A loading dose of 350 mg clopidogrel, followed by 75 mg daily, was added to the patient’s therapeutic regimen. The patient remained symptom-free after the procedure, and a treadmill exercise test was normal at two months following the procedure.

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Left coronary artery in different angiographic views: two stenoses are present, with an aneurysm in between them.

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Direct grafted stent placement before (left) and after (right) inflation. Note that the aneurysm is completely sealed and there is no residual stenosis.