Volume 14 - Issue 2 - February, 2002

Report of an Undeployed Stent Causing the Unraveling of a Coronary Artery Guidewire Being Used for Sidebranch Protection

Stephen T. Thew, MD and Lloyd W. Klein, MD

Coronary guidewire fracture and subsequent retrieval of the retained pieces is an uncommon, but known complication of percutaneous coronary angioplasty. To our knowledge, however, this is the first report of a coronary guidewire unraveling after positioning an undeployed stent, and its successful retrieval by removal of the undeployed stent.

Case Report. A 70-year-old male who had hypertension and hypercholesterolemia was treated with primary angioplasty of his proximal right coronary artery during an acute myocardial infarction 10 weeks prior to this admission. Because of continued...

Unusual Mechanism of Coronary Perforation During PTCA

Paolo Esente, MD, Ronald Caputo, MD, Carlton Levy, Alessandro Giambartolemei, MD, Alan Simons, MD, Mark Reger, MD, Gary Walford, MD

Case Description. A 79-year-old female with history of hypertension, hyperlipidemia and peripheral vascular disease underwent successful direct stenting of her left anterior descending coronary artery on March 15, 2000 in the setting of unstable angina, utilizing a 3.0 x 15 mm Medtronic/AVE S670 stent deployed at 16 atmospheres (Medtronic-AVE, Santa Clara, California). Follow-up coronary angiography on September 1, 2000 for recurrent angina revealed angiographically significant in-stent focal restenosis (Figure 1). Intravascular ultrasound (IVUS) was performed to address the possible un...

Facilitated Percutaneous Intervention Following Combination Therapy with Reteplase and Abciximab for Acute Myocardial Infarcti

Barry S. Weinstock, MD

Case Report. R.C. is a 45-year-old white male who presented to the Emergency Department at Largo Medical Center with a massive acute anterior wall myocardial infarction (MI). The patient denied any prior history of coronary artery disease (CAD), but admitted to intermittent chest pain over the preceding week. He had a moderately severe episode of chest pain lasting nearly 2 hours the evening before this event but the symptoms resolved spontaneously and he attributed the symptoms to indigestion. He was previously treated by his primary care physician with statin therapy for “mild” hy...

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