Fatal Vasospasm of the Coronary Arteries in a Patient Undergoing Distal Bypass Surgery and Endovascular Therapy for Threatened Lower Limbs Due to Acute Exacerbation of Peripheral Arterial Disease

A 79-year-old man with a heavy smoking history presented with threatened lower limbs due to acute exacerbation of peripheral artery disease (PAD). He underwent emergent distal bypass surgery for the right leg and external iliac stenting for the left leg. Fatal coronary artery spasm (CAS) with ST seg...

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Detalles Bibliográficos
Autores principales: Takeyoshi, Daisuke, Kikuchi, Shinsuke, Miyake, Keisuke, Tatsukawa, Takamitsu, Kobayashi, Daita, Uchida, Daiki, Kitani, Yuya, Kamiya, Hiroyuki, Azuma, Nobuyoshi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Japanese College of Angiology / The Japanese Society for Vascular Surgery / Japanese Society of Phlebology 2018
Materias:
Case Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6200607/
https://www.ncbi.nlm.nih.gov/pubmed/30402193
http://dx.doi.org/10.3400/avd.cr.18-00050
Descripción
Sumario:A 79-year-old man with a heavy smoking history presented with threatened lower limbs due to acute exacerbation of peripheral artery disease (PAD). He underwent emergent distal bypass surgery for the right leg and external iliac stenting for the left leg. Fatal coronary artery spasm (CAS) with ST segment changes on electrocardiography was observed 28 h after the procedures, resulting in cardiac arrest. Coronary angiography showed widespread CAS with improvement after intra-arterial nitroglycerin infusion. We should keep in mind that CAS may occur more frequently than expected in PAD patients, especially those who have not stopped smoking prior to revascularization.

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