Limits...
Slow-flow phenomenon after elective percutaneous coronary intervention of computed tomography-detected vulnerable coronary lesion.

Wolny R, Dębski A, Kruk M, Kępka C - Postepy Kardiol Interwencyjnej (2014)

Bottom Line: No-reflow or slow-flow phenomenon is one of the serious complications of percutaneous coronary interventions (PCI) in acute myocardial infarction, as well as during elective procedures, and is an independent predictor of myocardial infarction, and in-hospital and long-term mortality.We present a case of an elective PCI of native coronary artery lesion that was assessed to be vulnerable based on coronary computed tomography angiography, complicated with slow-flow phenomenon.

View Article: PubMed Central - PubMed

Affiliation: Institute of Cardiology, Warsaw, Poland.

ABSTRACT
No-reflow or slow-flow phenomenon is one of the serious complications of percutaneous coronary interventions (PCI) in acute myocardial infarction, as well as during elective procedures, and is an independent predictor of myocardial infarction, and in-hospital and long-term mortality. We present a case of an elective PCI of native coronary artery lesion that was assessed to be vulnerable based on coronary computed tomography angiography, complicated with slow-flow phenomenon.

No MeSH data available.


Related in: MedlinePlus

Final angiographic result of the PCI. TIMI 2 flow in the PDA. TIMI 3 flow in the OM; RAO 30, CAUD 30
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4252309&req=5

Figure 0005: Final angiographic result of the PCI. TIMI 2 flow in the PDA. TIMI 3 flow in the OM; RAO 30, CAUD 30

Mentions: The angiographic views of the tight, long lesion in the marginal branch are shown in Figure 2. Percutaneous coronary intervention was performed by transradial approach using a 6 Fr AL 2 guiding catheter. An intravenous bolus of 100 IU/kg unfractionated heparin (UFH) was administered. Posterior descending artery (PDA) and obtuse marginal branch were engaged with balance middle weight (BMW) guidewires. The lesion was pre-dilated with a 2.5 mm × 20 mm balloon (14 atm), and a 3.0 mm × 26 mm sirolimus-eluting stent was implanted to the marginal branch from the ostium of the vessel (Figure 3). After stent deployment there was TIMI 3 flow in OM and TIMI 1 flow with distal contrast medium staining in the PDA (Figure 4). The patient developed retrosternal chest pain, ST-segment elevation in the ECG, and III° atrioventricular block. Atropine and eptifibatide were administered intravenously, and sequential inflations of the 3.0 mm × 15 mm balloon were performed in the PDA. TIMI 2 flow was restored in the PDA (Figure 5), and gradual symptoms relief was achieved. The patient's stay in the intensive care unit (ICU) was complicated with atrial fibrillation treated with intravenous amiodarone. There was significant elevation of troponin T levels up to 1158 ng/l. In echocardiographic examination new hy-pokinesia of the basal segment of the lateral wall was observed. The Patient was discharged home within 6 days from the PCI.


Slow-flow phenomenon after elective percutaneous coronary intervention of computed tomography-detected vulnerable coronary lesion.

Wolny R, Dębski A, Kruk M, Kępka C - Postepy Kardiol Interwencyjnej (2014)

Final angiographic result of the PCI. TIMI 2 flow in the PDA. TIMI 3 flow in the OM; RAO 30, CAUD 30
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4252309&req=5

Figure 0005: Final angiographic result of the PCI. TIMI 2 flow in the PDA. TIMI 3 flow in the OM; RAO 30, CAUD 30
Mentions: The angiographic views of the tight, long lesion in the marginal branch are shown in Figure 2. Percutaneous coronary intervention was performed by transradial approach using a 6 Fr AL 2 guiding catheter. An intravenous bolus of 100 IU/kg unfractionated heparin (UFH) was administered. Posterior descending artery (PDA) and obtuse marginal branch were engaged with balance middle weight (BMW) guidewires. The lesion was pre-dilated with a 2.5 mm × 20 mm balloon (14 atm), and a 3.0 mm × 26 mm sirolimus-eluting stent was implanted to the marginal branch from the ostium of the vessel (Figure 3). After stent deployment there was TIMI 3 flow in OM and TIMI 1 flow with distal contrast medium staining in the PDA (Figure 4). The patient developed retrosternal chest pain, ST-segment elevation in the ECG, and III° atrioventricular block. Atropine and eptifibatide were administered intravenously, and sequential inflations of the 3.0 mm × 15 mm balloon were performed in the PDA. TIMI 2 flow was restored in the PDA (Figure 5), and gradual symptoms relief was achieved. The patient's stay in the intensive care unit (ICU) was complicated with atrial fibrillation treated with intravenous amiodarone. There was significant elevation of troponin T levels up to 1158 ng/l. In echocardiographic examination new hy-pokinesia of the basal segment of the lateral wall was observed. The Patient was discharged home within 6 days from the PCI.

Bottom Line: No-reflow or slow-flow phenomenon is one of the serious complications of percutaneous coronary interventions (PCI) in acute myocardial infarction, as well as during elective procedures, and is an independent predictor of myocardial infarction, and in-hospital and long-term mortality.We present a case of an elective PCI of native coronary artery lesion that was assessed to be vulnerable based on coronary computed tomography angiography, complicated with slow-flow phenomenon.

View Article: PubMed Central - PubMed

Affiliation: Institute of Cardiology, Warsaw, Poland.

ABSTRACT
No-reflow or slow-flow phenomenon is one of the serious complications of percutaneous coronary interventions (PCI) in acute myocardial infarction, as well as during elective procedures, and is an independent predictor of myocardial infarction, and in-hospital and long-term mortality. We present a case of an elective PCI of native coronary artery lesion that was assessed to be vulnerable based on coronary computed tomography angiography, complicated with slow-flow phenomenon.

No MeSH data available.


Related in: MedlinePlus