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A Stent On The Run Dr Khaled Almerri, MD Consultant interventonal cardiologist Chest disease hospital Kuwait


Case • 67 years gentelman • Cardiac risk factors – – – –

DM II Dyslipidemia No HTN Not smoker

• Had NSTEMI Dec 2011 • Dipyridamole myocardial perfusion scan :

– Large area of reversable defect in the inferior and inferoseptal area

• Echo :

– LVEF 50% mild inferior wall HK.


Case • Cath march 2012: – LM: normal – LAD : mild irregularity , no significant stenosis – CX : mild disease – RCA :significant damping with osteal 60% stenosis and long mid 95% – LV: normal


Treatment of the complication • To keep radial artery patent – Low pressure compression – Shorter time of compression – Anticoagulation

• Vascular consultation • Patent both ulnar and radial arteries at 3 months later


Take home message • Incidence 0.5% • Common in – Men – Calcification – With direct stenting – Kinks – RCA Kammler J et.al Am J Cardiol 2006; 98:367–369


Take home message • Can be lost in the coronary artery tree or outside – Intracoronary ( serious) • Retrieve • Deploy • Crush

– Outside into the vascular tree


THANKS


SHA24/089002