Coronary Vasospasm Presenting in a Catastrophic Way.

Coronary artery vasospasm is an under-recognized yet fatal condition that can manifest as sudden cardiac arrest. A 51-year-old man presented with out-of-hospital cardiac arrest due to ventricular fibrillation during exercise. Coronary angiogram showed severe disease at ostial left main coronary artery and left anterior descending artery (LAD), that was not present anymore on repeated angiography and intravascular ultrasound assessment.

Unprecedented guidewire entrapment salvaged by combined rotational atherectomy and 'Twist-wire' technique: a case report.

Background: Coronary guidewire entrapment is not an uncommon complication of percutaneous coronary intervention, especially in the setting of complex coronary anatomy. Core wire fracture with uncoiling of spring wire represents a catastrophic complication, posing great technical difficulty in percutaneous retrieval.

Case Summary: The patient was a 50-year-old Asian male with ischaemic cardiomyopathy and severe left ventricular impairment.

Use of chronic total occlusion wiring techniques for extremely angulated side branch access.

A 75-year-old man was admitted for non-ST-segment elevation myocardial infarction (NSTEMI).

The use of a homemade 'BAG' repositioning system to salvage complete coronary stent dislodgement.

A 71-year-old man who had undergone percutaneous transluminal coronary angioplasty (PTCA) in 2013 was admitted for unstable angina.

An extended use of the balloon deflection technique for difficult side branch wiring.

A 65-year-old man was admitted with non-ST-segment elevation myocardial infarction (NSTEMI). Coronary angiography showed a left dominant system with severe and diffuse left anterior descending artery (LAD) disease, necessitating percutaneous coronary intervention (PCI).

Myocardial hypoperfusion on conventional contrast computed tomography.

Non–electrocardiogram (ECG)–gated contrast computed tomography (CT) is commonly performed to exclude aortic dissection in chest pain patients. Besides evaluating the aorta for dissection flap, attention should be paid to the myocardium for areas of hypoenhancement that may suggest ischemia. Current models of multidetector CT enable assessment of myocardial perfusion with minimal motion artifact even without ECG gating.

Transcollateral retrograde diagnostic coronary angiogram - important therapeutic implications for an occluded arterial coronary artery bypass graft.

This case illustrates the potential clinical usefulness of retrograde approach for selective visualization of distal vessels in a patient with multiple coronary chronic total occlusions and previous coronary artery bypass graft (CABG) surgery. By knowing in extreme detail the exact anatomy of the complex post-surgical coronary system, a successful treatment can be planned for the patient.

Single 6 fr transradial guiding catheter for retrograde recanalization of left coronary artery chronic total occlusions: a case series.

The retrograde approach for percutaneous coronary intervention, using multiple arterial accesses for contralateral injection and large guiding catheters (7-8 Fr), has largely improved the success rate of recanalization of chronic total occlusions (CTOs). Radial approach and downsizing in this type of intervention are challenging. Our cases series demonstrates that in selected anatomies it is possible, feasible, and safe to perform single 6 Fr transradial guiding catheter retrograde recanalization of left-sided CTO via ipsilateral epicardial or septal collateral channels.