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Case studies in interventional cardiology by Martin T Rothman

By Martin T Rothman

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Example text

Fischman DL, Leon MB, Baim DS et al. A randomized comparison of coronary stent placement and balloon angioplasty in the treatment of coronary artery disease. N Engl J Med 1994; 331:496–501. 7. Park SJ, Park SWS, Mong MK et al. Stenting of unprotected left main coronary artery stenosis. Immediate and late outcomes. J Am Coll Cardiol 1998; 31:37–42. 8. Wong P, Wong V, Chan W et al. A prospective study of elective stenting in unprotected left main coronary disease. Cathet Cardiovasc Intervent 1999; 46:153–9.

The post-stenting image showed a widely patent lumen. 8. 5 × 22 mm noncompliant Ranger balloon inflated to 18 atmospheres. 9. The final angiographic result showed a widely patent lumen at the stent site with moderate distal disease. 10. The final angiographic image in the LAO; caudal projection also shows a widely patent lumen. There was an unexplained density indicated by the arrow. 11. The Cx intermediate artery has re-occluded at the stent site. Discussion This represents a case of unrecognized wire perforation resulting in pericardial tamponade 2 hours post-procedure.

3. 0 mm balloon dilation. 4. 5 × 8 mm stent. 5. Six months follow-up angiography showing patent stent, no evidence of restenosis. 5 mm balloon. A good result (Fig. 4) was achieved. Post-stenting IVUS (Fig. 6 mm2. The patient was kept on ASA 325 mg and clopidogrel 75 mg daily, and discharged well the next morning. At 6 months follow-up the patient was stable and asymptomatic, and angiography showed a patent stent with no evidence of restenosis. This patient was number 57 to undergo stenting of an unprotected LMCA stenosis in our center over the last 2 years.

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