Aterectomia rotacional multiarterial em lesão de tronco de coronária esquerda seguida de implante de stents
Multivessel rotational atherectomy in left main coronary artery lesion followed by stent implantation
Rev. bras. cardiol. invasiva; 23 (4), 2015
Publication year: 2015
Paciente com 82 anos, portadora de múltiplas comorbidades, com angina do peito apesar de terapia
medicamentosa otimizada. Submetida à coronariografia, que evidenciou doença triarterial com
envolvimento do tronco da coronária esquerda e intensa calcificação das artérias coronárias. A cirurgia
de revascularização miocárdica foi contraindicada, sendo encaminhada para intervenção coronária
percutânea, realizada em dois tempos, com intervalo de 15 meses. Primeiramente, a coronária esquerda
foi abordada, realizando-se aterectomia rotacional no tronco da coronária esquerda, artérias descendente
anterior e circunflexa, com implante de cinco stents farmacológicos com sucesso. Posteriormente, a
coronária direita foi tratada com aterectomia rotacional e implante de quatro stents farmacológicos,
também com sucesso
A 82-year-old patient with multiple comorbidities and angina, in spite of optimal drug therapy, was
submitted to coronary angiography, which showed three-vessel disease with left main coronary artery
involvement and severe coronary artery calcification. Coronary artery bypass grafting surgery was
contraindicated and the patient was referred for percutaneous coronary intervention, which was carried
out in two stages, with a 15-month interval between them. Firstly, the left coronary artery was treated
and rotational atherectomy was performed in the left main coronary artery, left anterior descending
and left circumflex arteries, with successful implantation of five drug-eluting stents. Subsequently, the
right coronary artery was treated with rotational atherectomy, and four drug-eluting stents were also
successfully implanted