Occlusion multivessel

V6) suggests multivessel involvement (Kurum et ah, 2002). In the STE-ACS due to the LAD occlusion proximal to D1 and SI (single-vessel disease), an ST-segment elevation may also be recorded from VI to V4, and ST-segment depression in V5-V6. However, in case of occlusion proximal to D1 and... 

When in a patient with STE-ACS in precordial leads there are some criteria that do not fit well with the presumed place of occlusion, the presence of ischaemia due to critical multivessel disease may be suspected (see Figure 4.44). It looks like a LAD occlusion proximal to D1 but was not clear if the occlusion was also proximal to SI (ST-segment elevation in VR and ST-segment depression in VI). The case corresponds to a critical... 

The electrocardiographic pattern of subendocardial injury in patients with ACSs is recorded in different leads, depending on the coronary artery involved and the location of the injured area. When the ischaemia is due to left main trunk (LMT) subocclusion or equivalent, or 3 proximal vessel diseases, the involvement of the left ventricle is circumferential. In case of single vessel disease or when in presence of multivessel disease, the active ischaemia is due to a culprit artery or two distal occlusions the involvement is considered regional (Sclarovsky 1989). The correlation between these... 

STE-ACS in patients with multivessel occlusion which is the culprit artery... 

Now we will discuss the importance of the catheterisation laboratory in a patient with multivessel disease, which is the culprit artery responsible of the ACS. In clinical practice, when an STE-ACS occurs, a critical occlusion has developed usually in only one culprit artery. In most cases, due to the fact that multivessel disease is often present, what is most important is that in the catheterisation laboratory, in a patient with STE-ACS and multivessel disease, the interventionist cardiologist may, thanks to the correct and quick interpretation of the ECG, take the correct decision on which coronary artery... 

V5, are seen in patients that may present with multivessel disease, usually very tight occlusion of proximal LAD + LCX (Figures 4.60 and 4.61), but also in case of LMT incomplete occlusion. 

This ACS with regional involvement is usually secondary to an incomplete coronary artery occlusion in patients frequently presenting with prior predominantly regional subendocardial ischaemia and single- or multivessel disease, but one culprit artery. Any coronary artery may be the culprit one and the occlusion often is not proximal (Table 8.2). 

PCI for Multivessel Disease and Complex Lesions 49 PCI for Left Main Disease 49 Bifurcation Stenting 51 PCI for Chronic Total Occlusions 51 PCI and CABG Complementary Rather than Competitive Strategies 54 Antiplatelet and Antithrombotic Therapies in PCI 54 Role of Newer Imaging Strategies and PCI 55... 

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