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Case report


Telescoping Technique to Engage Left Main Coronary Artery in a Case of Giant Aortic Aneurysm in a Geriatric Patient.

Priyank ShahRahul VasudevMahesh BikkinaHartaj Virk
Date of Submission: 11-Jun-2016, Date of Acceptance: 19-Sep-2016, Date of Web Publication: 21-Oct-2016.
Corresponding Author:

Rahul Vasudev

Department of Internal Medicine, New York Medical College, St. Joseph’s Regional Medical Center, Paterson, NJ 07503, USA.
E-mail: drrahulvasudev@gmail.com

Corresponding Author:

Rahul Vasudev

Department of Internal Medicine, New York Medical College, St. Joseph’s Regional Medical Center, Paterson, NJ 07503, USA.
E-mail: drrahulvasudev@gmail.com

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ABSTRACT


We present a case of a geriatric male with giant ascending aortic aneurysm (AAA) who underwent successful coronary angiography using telescoping technique for evaluation his coronary arteries before surgery for AAA. Since the ascending aorta and root were extremely dilated, we knew it would not have been possible to engage the coronaries using regular catheters and standard technique. Hence, telescopic technique was used. Amplatz left 3 (AL3) 7F (French) guide catheter (90 cm) was initially used, and nonselective injection of contrast was done to see the coronary ostium. After that, a 5F multipurpose catheter (110 cm) was telescoped through 7F AL3 guide catheter to engage the ostium of the left main coronary artery. Using this technique, images of coronaries were obtained, and it showed minimal luminal irregularities in major epicardial coronary arteries. The patient underwent successful surgery with aortic valve replacement and excision of aneurysm with graft placement. Although this technique has been described previously in enlarged aortas, this is the first to our knowledge use of telescoping technique in giant aortic aneurysm in a geriatric patient.
Keywords: Cardiac Catheterization, Cardiac Imaging And Giant Aortic Aneurysm, Telescoping Technique

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