Ostial lesions present many challenges for percutaneous coronary intervention （PCI）. Coronary anomaly will further increase difficulties in performing PCI for the patient. We present such a case as ostial occlusion ...Ostial lesions present many challenges for percutaneous coronary intervention （PCI）. Coronary anomaly will further increase difficulties in performing PCI for the patient. We present such a case as ostial occlusion of an right coronary artery with high takeoff. A 77-year-old male was referred to our institution with a diagnosis of non-ST elevated acute myocardial infarction. Selective coronary angiography and nonselective ascending aortography could not identify the origin of the right coronary artery. Multi-slices computed tomography showed RCA ostial totally occluded. A successful PCI was performed and a perfect final result was achieved utilized with many tips and tricks, including buddy wtre technique and focused-force angloplasty（J Genatr Cardio12009, 6：189-192）.展开更多
Based on different mechanisms of blood coagulation, coexistence of venous thromboembolism and arterial thrombosis in a single individual is extremely rare in clinical practice. Both antiplatelet and anticoagulation th...Based on different mechanisms of blood coagulation, coexistence of venous thromboembolism and arterial thrombosis in a single individual is extremely rare in clinical practice. Both antiplatelet and anticoagulation therapy should be adopted for patients with arteriovenous embolism. Balancing the risk of ischemia and hemorrhage is especially challenging in these patients in order to achieve an optimal clinical benefit. We report on a 55-year-old female with acute pulmonary embolism （PE）, subsequently diagnosed as having acute myocardial infarction （AMI） and a cerebral infarction. Examinations had been carried out, excluding potential arteriovenous shunts, cancer, an- tiphospholipid syndrome and other common hypercoagulable states. A combination of an anticoagulant drug （rivaroxaban, an Xa inhibitor） and an antiplatelet agent （clopidogrel, an ADP receptor inhibitor） was prescribed with a β-blocker and atorvastatin. The embolus was gradually shrunk during the next 10 months, and then it turned back into expanding. During the 16 months＇ follow-up, an aneurysm of left ventricular apex was found through an echocardiogram and an angiotensin-converting enzyme inhibitor was administered. We conclude that combined anticoagulation and antiplatelet therapy significantly relieved the symptoms and improved the prognosis in patients suffering from arteriovenous embolism without any major clinical bleeding events.展开更多
文摘Ostial lesions present many challenges for percutaneous coronary intervention （PCI）. Coronary anomaly will further increase difficulties in performing PCI for the patient. We present such a case as ostial occlusion of an right coronary artery with high takeoff. A 77-year-old male was referred to our institution with a diagnosis of non-ST elevated acute myocardial infarction. Selective coronary angiography and nonselective ascending aortography could not identify the origin of the right coronary artery. Multi-slices computed tomography showed RCA ostial totally occluded. A successful PCI was performed and a perfect final result was achieved utilized with many tips and tricks, including buddy wtre technique and focused-force angloplasty（J Genatr Cardio12009, 6：189-192）.
基金Project supported by the National Natural Science Foundation of China （Nos. 31171392 and 31371475）
文摘Based on different mechanisms of blood coagulation, coexistence of venous thromboembolism and arterial thrombosis in a single individual is extremely rare in clinical practice. Both antiplatelet and anticoagulation therapy should be adopted for patients with arteriovenous embolism. Balancing the risk of ischemia and hemorrhage is especially challenging in these patients in order to achieve an optimal clinical benefit. We report on a 55-year-old female with acute pulmonary embolism （PE）, subsequently diagnosed as having acute myocardial infarction （AMI） and a cerebral infarction. Examinations had been carried out, excluding potential arteriovenous shunts, cancer, an- tiphospholipid syndrome and other common hypercoagulable states. A combination of an anticoagulant drug （rivaroxaban, an Xa inhibitor） and an antiplatelet agent （clopidogrel, an ADP receptor inhibitor） was prescribed with a β-blocker and atorvastatin. The embolus was gradually shrunk during the next 10 months, and then it turned back into expanding. During the 16 months＇ follow-up, an aneurysm of left ventricular apex was found through an echocardiogram and an angiotensin-converting enzyme inhibitor was administered. We conclude that combined anticoagulation and antiplatelet therapy significantly relieved the symptoms and improved the prognosis in patients suffering from arteriovenous embolism without any major clinical bleeding events.
