Percutaneous transluminal dilatation of proximal stenosis of left anterior descending coronary artery in patient with bronchogenic carcinoma.

Abstract

shadows were noted in the mid-zone of the right lung ( Fig. 2), each of which proved, upon needle biopsy, to be a small round cell anaplastic carcinoma. Although thc acute ischaemic episode appeared to have resolved, the patient continued to have severe angina despite treatment with propranolol (120 mg), and isosorbide dinitrate (60 mg), and this was the indication for an attempt at percutaneous transluminal coronary angioplasty. Method Under local anaesthesia, and by the Seldinger technique, a preshaped guiding cathetert was passed from the right femoral artery into the ascending aorta. Through this catheter a double-lumen dilatation catheter was guided into the ostium of the left coronary artery. At its tip the dilatation catheter has a distensible balloon segment of maximum diameter 3 mm. The balloon was introduced fully deflated into the left anterior descending artery, and positioned in the stenosis. It was then inflated with a mixture of 50 per cent contrast medium (76% Urografin) and saline, using an automatic calibrated pump. Three inflations were made using a pressure of 5 atmospheres to obtain maximum distension of the balloon in the stenosis without affecting the normal portion of the artery. Details of the method are described elsewhere.6 Dilatation was performed by AG. ResultsThe lumen of the left anterior descending artery