Coronary Artery Hematoma Treated with Fenestration Using a Novel NSE Alpha® Scoring Balloon

Figures

• 

  Figure 1. Baseline coronary angiography showed severe luminal stenosis of the mid left circumflex artery (head arrow).

• 

  Figure 2. Angiography after stenting showed mild luminal narrowing with a dissection at the distal left circumflex artery (arrow).

• 

  Figure 3. Emergent angiography revealed occlusion of the distal segment of the left circumflex artery (dotted arrow).

• 

  Figure 4. IVUS revealed progression of the intramural hematoma (H) and a totally compressed true lumen at the distal left circumflex artery. An intramural hematoma appears as a homogeneous, hyperechoic, crescent-shaped area.

• 

  Figure 5. A novel scoring balloon (arrow: NSE Alpha 2.5 × 13 mm, Goodman, Japan) was dilated in the far distal LCX.

• 

  Figure 6. IVUS after fenestration with a scoring balloon showed the resolution of the hyperechoic area within the hematoma space (∗).

• 

  Figure 7. Angiography after fenestration showed Thrombolysis in Myocardial Infarction 3 (TIMI-3) flow.

• 

  Figure 8. The NSE Alpha has 3 longitudinal nylon triangle elements mounted on the balloon surface to prevent balloon slippage during inflation.