Introduction: Coronary chronic total occlusions (CTOs) are commonly encountered during diagnostic angiograms. With recent advances, especially in experienced centers, success rates with CTO percutaneous coronary intervention (PCI) have approached 80% or higher. It is important to note that despite these advancements in techniques, CTOs remain difficult to treat. We present a case of a left circumflex artery (LCX) CTO that was successfully revascularized using a microcatheter balloon pinning technique that allowed additional wire support.
Case Report: A 77-year-old woman status post-two-vessel coronary artery bypass graft surgery presented with new onset angina at rest and was found to have a patent graft to the left anterior descending artery, and an unrevascularized proximal LCX CTO. PCI was attempted with a microcatheter using an antegrade approach. This approach was unsuccessful due to the lack of support and the left circumflex angle. As a result, we used a balloon to pin the microcatheter to the wall of the left main to allow for successful wiring of the LCX. A stent was successfully deployed in the LCX, and the patient was discharged from the hospital 2 days later. At follow-up, the patient was asymptomatic and returned to her usual activity.
Discussion: After conducting a thorough literature search, it appears that this is the first case that a microcatheter has been pinned with a balloon. We believe that in LCX CTOs that require support, the microcatheter pinning technique can provide adequate support in wiring CTO's. LCX CTOs can be very difficult to treat, we present a case of a LCX CTO that required the use of the microcatheter balloon pinning technique to allow additional wire support for successful wiring and ultimately treatment.
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http://dx.doi.org/10.1111/1755-5922.12290 | DOI Listing |
J Orthop Surg Res
January 2025
Department of Orthopedics, Beijing Chaoyang Hospital, Capital Medical University, 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing, 100020, China.
Background: Finite element analysis (FEA) could advance the understanding of fracture fixation and guide the choice of surgical treatment. This study aimed to compare two internal fixation methods in the treatment of displaced proximal humeral fracture (PHF) through FEA.
Methods: Three-dimensional FEA model based on the left shoulder joint of a 67-year-old female patient with PHFs and osteoporosis was adopted, in order to analyze the fixation effect and load stress distribution of internal fixation plates with open reduction and intramedullary nails without opening the fracture in the treatment of Neer III-VI PHF.
Arch Orthop Trauma Surg
January 2025
Department of Hand, Plastic, Reconstructive and Burn Surgery, BG Unfallklinik Tuebingen, Eberhard Karls University Tuebingen, Tübingen, Germany.
Introduction: Perilunate dislocations (PLD) and perilunate fracture-dislocations (PLFD) are high-energy wrist injuries often linked to significant post-traumatic osteoarthritis. This study aims to determine whether PLD and PLFD yield different radiological outcomes following surgical treatment while identifying prognostic factors for worse outcomes.
Materials And Methods: We retrospectively analyzed 51 patients treated for perilunate injuries between 2000 and 2022.
BMC Musculoskelet Disord
January 2025
Department of Orthopaedics Surgery, National Children's Medical Center & Children's Hospital of Fudan University, Wanyuan Road 399, Minhang District, Shanghai, 201102, China.
Background: Congenital Pseudarthrosis of the Tibia (CPT) is a rare pediatric condition presenting substantial challenges for orthopedic surgeons. Aiming to achieve bone union, with subsequent complications such as refractures being common. The aim of the present study is to evaluate the results of our intentional cross-union protocol and to compare these outcomes with those obtained from our previously used techniques.
View Article and Find Full Text PDFMymensingh Med J
January 2025
Dr Md Sonaullah, Assistant Professor, Department of Orthopedics and Traumatology, Mymensingh Medical College (MMC), Mymensingh, Bangladesh; E-mail:
Subtrochanteric femoral fractures are one of the common fractures encountered in today's Orthopaedic practice. This area consists of mostly cortical bone with high stress generation thus heal slowly which leads implant failure. The inherent instability of this fracture and forces of the muscles with comminuted medial calcar is giving the fracture a tendency to varus collapse.
View Article and Find Full Text PDFEur J Orthop Surg Traumatol
December 2024
Department of Orthopedics and Trauma, Universidade Federal Fluminense (UFF), Niterói, Rio de Janeiro, Brazil.
Purpose: Although several techniques have been described for bent intramedullary nail removal, there is no universally accepted strategy. We hypothesized that a device based on the action principle of a three-point bend fixture could facilitate extraction of bent intramedullary nails; this paper describes its design and experimental testing.
Methods: Five large synthetic left femurs and five steel intramedullary nails were used.
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