This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Van Langenhove, G. Articles by Serruys, P. W. Search for Related Content PubMed PubMed Citation Articles by Van Langenhove, G. Articles by Serruys, P. W.

(Circulation. 2000;102:e95.)
© 2000 American Heart Association, Inc.

Images in Cardiovascular Medicine

Distal Embolization

A Threat to the Coronary Artery?

Glenn Van Langenhove, MD; Leonidas Diamantopoulos, MD; Evelyn Regar, MD; David P. Foley, MD; Jan Tuin, BSc; Stephane G. Carlier, MD; Patrick W. Serruys, MD

From the Department of Interventional Cardiology, Thoraxcenter Rotterdam, Erasmus University Hospital, Rotterdam, The Netherlands.

Correspondence to P. W. Serruys, Thoraxcenter, Bd 418, University Hospital Dijkzigt, Dr Molewaterplein 40, 3015 GD Rotterdam, The Netherlands. E-mail Serruys{at}card.azr.nl

A67-year-old man with a history of hypertension and hypercholesterolemia was scheduled for elective direct stent implantation for a severe proximal left descending artery stenosis. Using the femoral approach, a 7-French Judkins left guiding catheter was placed in the left coronary ostium. To keep the activated clotting time >300 s, 10 000 IU of heparin and 250 mg of aspirin were given intravenously. After introducing an intermediate guide wire (Guidant Inc), we placed an Angioguard^TM (Angioguard Inc) distal to the target lesion. This guidewire-based, filter-type device captures embolic debris while maintaining distal perfusion by means of an expandable umbrella. Successful direct stenting was performed with an Tristar 3.5/18-mm premounted stent (Guidant Inc) at an inflation pressure of 18 atm.

Final coronary angiography showed a good result (24% diameter stenosis by online quantitative coronary angiography) and TIMI 3 flow. When retrieving the Angioguard^TM device, we found it filled with tiny white fibers (Figure, a and b), which were obviously from the swabs used to clean the angioplasty wire during the procedure (Figure, c and d). Only once before has swab fiber material been described in pathological specimens.¹ Direct evidence for such a finding is available from this case.

View larger version (120K): [in this window] [in a new window]   Figure 1. a and b, AngioguardTM device after retrieval from the coronary artery. Tiny white fibers can be seen. c and d, Closeup view of swab used to clean the angioplasty wire. The same fibers are present.

References

1. Whelan DM, van Beusekom HM, van der Giessen WJ. Foreign body contamination during stent implantation. Cathet Cardiovasc Diagn.. 1997;40:328–332.[Medline] [Order article via Infotrieve]
   

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Van Langenhove, G. Articles by Serruys, P. W. Search for Related Content PubMed PubMed Citation Articles by Van Langenhove, G. Articles by Serruys, P. W.