“Side-branch occlusion (SBO) of coronary arteries arising

“Side-branch occlusion (SBO) of coronary arteries arising from an atherosclerotic coronary Libraries segment may happen during percutaneous coronary angioplasty (PTCA) [1], [2] and [3]. Accidental occlusion of atrial coronary branches could also occur after PTCA (see Fig. 1), but the incidence of this complication is unknown. Atrial arteries arise from the right and circumflex coronary arteries and extend through the atrial myocardium to supply Selleck Antidiabetic Compound Library both chambers. It is therefore conceivable that PTCA of lesions located at the right or circumflex coronary arteries could lead to an accidental atrial branch occlusion (ABO). However, the incidence and risk factors related to this complication have

not been systematically analyzed and only one study reports the incidence of occlusion of sinus node artery in patients undergoing right coronary angioplasty [4]. The clinical relevance of ABO is not well established. There is indirect evidence from clinical and necropsic studies [5], [6], [7], [8], [9], [10] and [11] to support the hypothesis that,

like it occurs during ventricular myocardial ischemia [12], [13] and [14], ZD6474 datasheet atrial myocardial ischemia secondary to ABO might lead to mechanical atrial dysfunction, increased electrical vulnerability to atrial arrhythmias, and late structural remodeling. The aim of our study was to analyze the incidence of accidental ABO during elective PTCA of the right and circumflex coronary arteries in an experienced coronary interventional center. Moreover, we compare the clinical profile and technical

procedural characteristics in patients with and without accidental ABO after elective PTCA. From a total number of 2149 PTCAs performed between January 1, 2009 and February 28, 2011 in our institution, we retrospectively reviewed the 845 consecutive elective procedures involving the right and circumflex coronary arteries. Therefore, we finally include the 200 patients in whom the placement of the stent could interfere the atrial branch flow. This could happen when a) the treatment of target lesion forces to place the stent across the origin of atrial artery, or about b) the distance between the extreme of the stent and the origin of atrial branch is less than or equal to 5 mm assessed by Quantitative Coronary Assessment (QCA) software (Philips Allura Xper FD 10). In order to facilitate the use of our data in future prospective studies addressed to determine the clinical consequences of isolated atrial ischemia, patients submitted to PTCA in the setting of acute myocardial infarction were not included. All patients were admitted to the hospital at least 1 day before the intervention. In all cases the clinical history, physical examination, 12-lead ECG, routine blood test, and myocardial markers were collected retrospectively whenever available.

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