Lepirudin as a safe alternative for effective anticoagulation in patients with known heparin-induced thrombocytopenia undergoing percutaneous coronary intervention: Case reports

Cardiovascular abnormalities are well-known manifestations of tertiary syphilis infections which although not frequent, are still causes of morbidity and mortality. A less common manifestation of syphilitic aortitis is coronary artery ostial narrowing related to aortic wall thickening. We report a case of a 46-year-old male admitted due to acute anterior ST elevation myocardial infarction submitted to primary percutaneous coronary intervention successfully. Coronary angiography showed a suboccluded ostial lesion of left main coronary artery. VDRL was titrated to 1/512. The patient was discharged with treatment including benzathine penicillin. Previous case reports of acute myocardial infarction in association with syphilitic coronary artery ostial stenosis have been reported, but the fact that the patient was treated by percutaneous coronary intervention is unique in this case.

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Percutaneous Coronary Intervention for High Takeoff Left Main Coronary Artery: A Case Report

Indian Journal of Cardiovascular Disease in Women WINCARS ◽

10.1055/s-0039-1683952 ◽

2018 ◽

Vol 03 (04) ◽

pp. 237-239

Author(s):

Seetharam Vankudoth ◽

Madhurima Banoth

Keyword(s):

Percutaneous Coronary Intervention ◽

Case Reports ◽

Coronary Intervention ◽

Anterior Wall ◽

Left Main ◽

Stent Restenosis ◽

Percutaneous Coronary ◽

The Right ◽

Diagnostic Catheter ◽

Guiding Catheter

AbstractPercutaneous coronary intervention (PCI) for high takeoff left main is challenging, as it poses difficulties with the engagement of the guiding catheter and establishment of backup support. This report examines the case of a 53-year-old woman with history of anterior wall myocardial infarction with a ventricular septal defect (VSD), who was treated with left anterior descending (LAD) angioplasty and VSD device closure done 4 years back, and now she presented with unstable angina. After successful engagement of 5F Tiger diagnostic catheter through a right radial artery, the angiography revealed an 80% stenosis of the proximal LAD and in-stent restenosis 70% of mid-LAD. The authors tried to engage the left coronary system through the right femoral artery with 6F Judkins left, 6F Amplatzer left, 6F EBU, and 6F XBU. They could not cannulate because of high takeoff left main, so they switched to right radial access. Then they engaged a 6F 3.5 EBU catheter. Due to the weak backup support of the guiding catheter, they used another wire to stabilize it and the stent was implanted successfully. This is one of the rare case reports of PCI for high takeoff left main.

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Combination platelet glycoprotein IIb/IIIa receptor and lepirudin administration during percutaneous coronary intervention in patients with heparin-induced thrombocytopenia

Catheterization and Cardiovascular Interventions ◽

10.1002/ccd.10393 ◽

2002 ◽

Vol 58 (1) ◽

pp. 65-68 ◽

Cited By ~ 6

Author(s):

Duane S. Pinto ◽

Robert T. Sperling ◽

Thomas M. Tu ◽

David J. Cohen ◽

Joseph P. Carrozza

Keyword(s):

Percutaneous Coronary Intervention ◽

Coronary Intervention ◽

Platelet Glycoprotein ◽

Heparin Induced Thrombocytopenia ◽

Percutaneous Coronary

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Is left main percutaneous coronary intervention justified in the presence of concomitant complex coronary artery disease – immediate and remote results – single Bulgarian center experience

Bulgarian Cardiology ◽

10.3897/bgcardio.26.e54126 ◽

2020 ◽

Vol 26 (3) ◽

pp. 43-51

Author(s):

Ivayla Zheleva-Kyuchukova ◽

Valeri Gelev

Keyword(s):

Percutaneous Coronary Intervention ◽

Coronary Artery ◽

Coronary Intervention ◽

Drug Eluting Stent ◽

Vascular Events ◽

Safe Alternative ◽

Complex Anatomy ◽

Percutaneous Coronary ◽

I 32

Revascularization in patients with severe stenosis of left coronary artery (LCAS) trunk signiﬁ cantly improves their prognosis. Modern clinical studies, registries and meta-analyses have identiﬁ ed percutaneous coronary intervention (PCI) of LCAS as a safe alternative to aorto-coronary bypass (ACB) in patients with low and intermediate lesion complexity. Aims: To conﬁ rm the safety and effectiveness of PCI and implantation of second generation drug eluting stent (DES) in patients with unprotected LCAS and concomitant complex coronary pathology. Material and Methods: For the period March 2013–October 2018 we performed 225 PCIs of patients with LCAS. 170 of patients who received PCI were divided into 2 groups, according to their SS-1 (ST elevation excluded). We analyzed the major adverse cardio-vascular events (MACE – all-cause mortality, cardiac mortality, stroke and ischemia driven TLR) rate and time-to-ﬁ rst MACE during follow up. Results: 103 patients had SS-I < 32 and 67 patients had SS-I ≥ 32 and their mean age was 67,25 ± 11,03. The median follow-up was 26,6 ± 19,1 months. MACE rate was 12,4% and there was no signiﬁ cance between groups (p = 0,118). Conclusions: PCI of unprotected LCAS has high procedural success rate and good mid-term results, even in pts with complex anatomy. High anatomical complexity of coronary lesions deﬁ ned by SS-I ≥ 32 is not predictive for poor clinical outcome after PCI.

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