Stent implantation and optical frequency domain imaging with carbon dioxide for chronic total occlusion in the superfici
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CASE REPORT
Stent implantation and optical frequency domain imaging with carbon dioxide for chronic total occlusion in the superficial femoral artery Akihiro Nakamura • Kazuki Noda • Sota Nakajima • Hideaki Endo • Tohru Takahashi Eiji Nozaki
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Received: 29 August 2014 / Accepted: 6 October 2014 Ó Japanese Association of Cardiovascular Intervention and Therapeutics 2014
Abstract A 68-year-old female was presented with claudication in the left lower leg. She underwent angiography with carbon dioxide (CO2) because she had a history of anaphylactic shock to iodinated contrast medium. It revealed total occlusion of the left superficial femoral artery (SFA), and subsequently endovascular therapy (EVT) was performed by an antegrade approach from the left common femoral artery. After stent implantation, we performed optical frequency domain imaging (OFDI) using CO2 as contrast medium. OFDI has been extensively studied in the coronary circulation; however, its use in the peripheral arterial circulation is scarce. We present a case of stent implantation and OFDI using CO2 as an ancillary tool during EVT for SFA lesions in the patient with contraindication to iodinated contrast medium.
system. Its system is similar to that of intravascular ultrasound (IVUS) and provides a 10-fold higher resolution as compared to IVUS. Although OFDI has now become available in the coronary intervention in Japan, its use has limited in the setting of infrainguinal peripheral artery disease (PAD). The following report is a case of patient with anaphylactic shock to iodinated contrast medium who underwent endovascular therapy (EVT) using CO2 for a total occlusion lesion in the left superficial femoral artery (SFA). In this case, we had a unique opportunity for OFDI imaging using CO2 before and after stent implantation in SFA lesions which cannot be performed in coronary imaging.
Case presentation Keywords Carbon dioxide Stenting Superficial femoral artery Optical frequency domain imaging
Introduction The use of iodinated contrast medium is limited or contraindicated in patients with impaired renal function or a history of anaphylactic shock induced by this agent. In such patients, carbon dioxide (CO2) is available as medium for digital subtraction angiography. Intravascular optical frequency domain imaging (OFDI) is a new imaging modality based on near-infrared light projected via a catheter-based
A. Nakamura (&) K. Noda S. Nakajima H. Endo T. Takahashi E. Nozaki Department of Cardiology, Iwate Prefectural Central Hospital, 1-4-1 Ueda, Morioka, Iwate 020-0096, Japan e-mail: [email protected]
In April 2013, a 68-year-old female patient who presented a clinical medical history of hypertension, diabetes mellitus, smoking, dyslipidemia was referred to our hospital for a 3-month history of intermittent claudication (Fontain classification: IIb) in her left leg. The patient had a surgical history of femoropopliteal prosthetic bypass graft in both legs for total occlusion of the superficial femoral artery (SFA) 9 years
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