"One-stop" endovascular treatment for concomitant coronary heart disease and aortic atherosclerotic disease
Objective: To investigate the clinical strategies and safety of “one-stop" solution by combination of percutaneous coronary intervention (PCI) endovascular aortic repair (EVAR) for concomitant coronary heart disease and aortic atherosclerotic disease. Methods: The clinical data of 7 patients with aortic atherosclerotic disease and concomitant coronary heart disease undergoing endovascular treatment in Fuwai Hospital from January 2016 to June 2016 were retrospectively analyzed. Of the patients, 6 cases were male and 1 case was female, with an average of 76.2 (64–86) years of age; the co-existence of aortic atherosclerotic disease and coronary heart disease was confirmed by preoperative aortic and coronary CT imaging, and all underwent “one-stop” operation after verification of indications for interventional therapy in both aortic and coronary artery lesions by intraoperative angiography. Results: The operative success rate was 100% and no perioperative death occurred. Postoperative complications included subcutaneous ecchymosis near the incision site in 2 cases, of whom, 1 case complicated with hematoma and given transfusion received 2 U packed red blood cells due to hemoglobin decline. One case with descending aortic arch ulcer undergoing reconstruction of the left subclavian artery by chimney technique, developed pseudoaneurysm at the puncture site of the left brachial artery, and then underwent surgical repair. All patients were followed up by outpatient visit or telephone contact, and during the follow-up period of 7 (6–10) months, their symptoms had disappeared or were significantly alleviated, with improved quality of life; no repeat operation was required and no death occurred. Conclusion: “One-stop” treatment by PCI and EVAR for concomitant coronary heart disease and aortic atherosclerotic disease has satisfactory short- and mid-term efficacy, and precaution should be taken for the hemorrhagic complications in the incision and puncture site. Postoperative medications should be strictly given according to the principle for coronary heart disease treatment.