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Hybrid single staged treatment of coronary arteries and aorto-iliac obstruction disease: a case report

BACKGROUND: If the internal thoracic artery is a collateral circulation to the lower extremities, careful consideration should be given to its use when coronary artery bypass grafting is required. We report a case of CABG with bilateral common iliac artery lesions and collateral circulation from the...

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Autores principales: Kasama, Keiichiro, Uranaka, Yasuko, Tomita, Hiroto, Matsumoto, Atsushi, Suzuki, Shinichi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8935847/
https://www.ncbi.nlm.nih.gov/pubmed/35313915
http://dx.doi.org/10.1186/s13019-022-01797-8
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author Kasama, Keiichiro
Uranaka, Yasuko
Tomita, Hiroto
Matsumoto, Atsushi
Suzuki, Shinichi
author_facet Kasama, Keiichiro
Uranaka, Yasuko
Tomita, Hiroto
Matsumoto, Atsushi
Suzuki, Shinichi
author_sort Kasama, Keiichiro
collection PubMed
description BACKGROUND: If the internal thoracic artery is a collateral circulation to the lower extremities, careful consideration should be given to its use when coronary artery bypass grafting is required. We report a case of CABG with bilateral common iliac artery lesions and collateral circulation from the bilateral ITAs on the peripheral side. CASE PRESENTATION: A 58-year-old man was admitted to our department with claudication and dyspnea upon exertion. He was diagnosed with right common iliac artery obstruction and 90% stenosis of the left common iliac artery. Coronary angiography revealed three-vessel disease with 50% stenosis of the left main trunk. The bilateral ITA showed a rich collateral flow to the lower extremities. Hybrid single staged repair with percutaneous transluminal angioplasty for the left iliac lesion was performed, followed by off-pump coronary artery bypass grafting (CABG) and femoro-femoral crossover bypass. Postoperative angiography revealed that all grafts were patent. The postoperative course was uneventful, except that the patient’s creatinine kinase level increased to 7177 U/L on postoperative day 1. CONCLUSION: To treat coronary artery disease with peripheral artery disease, especially those with iliac artery occlusion lesions with collateral circulation from the ITA, not only graft selection but also the treatment strategies for peripheral lesions are considered extremely important. Hybrid single staged coronary and lower limb artery revascularization could be safely achieved by multidisciplinary team strategies.
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spelling pubmed-89358472022-03-23 Hybrid single staged treatment of coronary arteries and aorto-iliac obstruction disease: a case report Kasama, Keiichiro Uranaka, Yasuko Tomita, Hiroto Matsumoto, Atsushi Suzuki, Shinichi J Cardiothorac Surg Case Report BACKGROUND: If the internal thoracic artery is a collateral circulation to the lower extremities, careful consideration should be given to its use when coronary artery bypass grafting is required. We report a case of CABG with bilateral common iliac artery lesions and collateral circulation from the bilateral ITAs on the peripheral side. CASE PRESENTATION: A 58-year-old man was admitted to our department with claudication and dyspnea upon exertion. He was diagnosed with right common iliac artery obstruction and 90% stenosis of the left common iliac artery. Coronary angiography revealed three-vessel disease with 50% stenosis of the left main trunk. The bilateral ITA showed a rich collateral flow to the lower extremities. Hybrid single staged repair with percutaneous transluminal angioplasty for the left iliac lesion was performed, followed by off-pump coronary artery bypass grafting (CABG) and femoro-femoral crossover bypass. Postoperative angiography revealed that all grafts were patent. The postoperative course was uneventful, except that the patient’s creatinine kinase level increased to 7177 U/L on postoperative day 1. CONCLUSION: To treat coronary artery disease with peripheral artery disease, especially those with iliac artery occlusion lesions with collateral circulation from the ITA, not only graft selection but also the treatment strategies for peripheral lesions are considered extremely important. Hybrid single staged coronary and lower limb artery revascularization could be safely achieved by multidisciplinary team strategies. BioMed Central 2022-03-21 /pmc/articles/PMC8935847/ /pubmed/35313915 http://dx.doi.org/10.1186/s13019-022-01797-8 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Case Report
Kasama, Keiichiro
Uranaka, Yasuko
Tomita, Hiroto
Matsumoto, Atsushi
Suzuki, Shinichi
Hybrid single staged treatment of coronary arteries and aorto-iliac obstruction disease: a case report
title Hybrid single staged treatment of coronary arteries and aorto-iliac obstruction disease: a case report
title_full Hybrid single staged treatment of coronary arteries and aorto-iliac obstruction disease: a case report
title_fullStr Hybrid single staged treatment of coronary arteries and aorto-iliac obstruction disease: a case report
title_full_unstemmed Hybrid single staged treatment of coronary arteries and aorto-iliac obstruction disease: a case report
title_short Hybrid single staged treatment of coronary arteries and aorto-iliac obstruction disease: a case report
title_sort hybrid single staged treatment of coronary arteries and aorto-iliac obstruction disease: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8935847/
https://www.ncbi.nlm.nih.gov/pubmed/35313915
http://dx.doi.org/10.1186/s13019-022-01797-8
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