Acute coronary and cerebrovascular syndrome

EuroIntervention 2016;12:758. DOI: 10.4244/EIJV12I6A122

Ronald K. Binder
Ronald K. Binder1*, MD; Agnes Straub1, MD; Thomas F. Lüscher1, MD; Marc Husmann2, MD
1. University Heart Center, Department of Cardiology, University Hospital Zürich, Zürich, Switzerland; 2. Department of Angiology, University Hospital Zürich, Zürich, Switzerland

A 78-year-old patient with a history of coronary artery bypass grafting, percutaneous coronary intervention and transcatheter aortic valve implantation (Panel A, THV) was admitted with crescendo angina, dizziness, left arm fatigue and elevated troponin. An angiogram (Panel A) showed chronically occluded right (RCA) and left (LCA) coronary arteries and a chronic in-stent occlusion of the vein graft (V-RCX) to the marginal branch. The left internal mammary graft (LIMA) to the left anterior descending artery could not be intubated because of a new, subtotal stenosis in the left subclavian artery (Panel B). Via a retrograde left brachial approach, the ...

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