[Coronary sinus reducer : Technical aspects, prevention and management of potential complications]. / Réducteur de sinus coronaire : aspects techniques, prévention et gestion des complications.

Coronary sinus reducer implantation is a percutaneous technique creating a narrowing in the coronary sinus through the implantation of an hourglass-shaped endoprosthesis. It is proposed to reduce symptoms in patients suffering from refractory angina pectoris. This innovative treatment is experiencing a major craze among interventional cardiologists. It is associated with very high procedural success rates. Complications are rare and include coronary sinus dissection or perforation and migration of the device. This review exposes the device implantation technique, the potential anatomical difficulties, the tips and tricks to overcome challenging situations. It also focuses on the prevention and management of potential complications.

How to manage an entrapped undeflatable coronary balloon.

An entrapped undeflatable coronary balloon is a rare complication during percutaneous coronary intervention. It is a complication that can be stressful for the operator, with potentially catastrophic implications for the patient. A fully inflated balloon in the coronaries impedes the blood flow to the distal myocardium and hence causes ischemia, that could jeopardize the hemodynamics of the patients and potentially lead to life-threatening complications. In this article, we go over the bail-out techniques that have been tried while highlighting the pros and cons of each technique.

3D Stent Reconstruction Using CMCT: A Novel Method to Assess Stent Expansion.

Stent underexpansion in calcified coronary stenosis is an important predictor of major short- and long-term adverse cardiovascular events. In this case, we describe a novel method for assessing stent expansion using 3-dimensional stent reconstruction with C-arm motion compensated computed tomography.

[Cardiac magnetic resonance imaging and coronary optical coherence tomography : Acquisition techniques, interpretation and integration in diagnostic algorithms for MINOCA]. / Imagerie par résonance magnétique et imagerie endocoronaire par tomographie par cohérence optique : acquisition, interprétation et intégration dans le diagnostic étiologique des MINOCA.

MINOCA is a heterogeneous entity with many possible etiologies that need to be clarified to optimize therapeutic interventions. Common causes include plaque disruption, plaque erosion, spontaneous coronary artery dissection, coronary artery spasm, coronary thromboembolism. Most of the time, coronary angiography is inadequate to obtain the proper identification of these underlying pathophysiological mechanisms. Within this context, myocardial tissue characterization with magnetic resonance imaging is key investigation to assess and locate recent myocardial infarctions and to exclude differential diagnostics such as myocarditis or takotsubo cardiomyopathy. In addition, optical coherence tomography is a powerful tool to visualize coronary intraluminal and superficial coronary artery structures in detail including the detection of plaque disruption signs, thrombus or dissections. The use of appropriate diagnostic algorithms combining both OCT and CMR seems to provide a clear substrate or diagnosis to many of the cases. This narrative review aims to expose both imaging modalities focusing on their contributions in the setting of MINOCA.