International Journal of Cardiovascular ResearchISSN: 2324-8602

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Case Report, Int J Cardiovasc Res Vol: 3 Issue: 3

Acute Severe Ischemia Following Protected Distal Left Main Stenting for Recurrent Drug-Eluting Instent Restenosis: A Potential New Mechanism for Side-Branch Ischemia

Baskaran Chandrasekar*, Mohammad Al Mutairi1, Ibrahim Al Rashdan1, and Khaled Al Merri1
Department of Cardiology, Kuwait Heart Center - Chest Diseases Hospital, Shuwaikh, Kuwait
Corresponding author : Baskaran Chandrasekar
Department of Cardiology, Cardiac Cath lab, Kuwait Heart Center - Chest Diseases Hospital, Jamal Abdul Nasser Street, Shuwaikh, Kuwait
Tel: +96524817987
E-mail: [email protected]
Received: May 02, 2014 Accepted: June 19, 2014 Published: June 24, 2014
Citation: Chandrasekar B, Mutairi MA, Rashdan IA, Merri KA (2014) Acute Severe Ischemia Following Protected Distal Left Main Stenting for Recurrent Drug- Eluting Instent Restenosis: A Potential New Mechanism for Side-Branch Ischemia. Int J Cardiovasc Res 3:3. doi:10.4172/2324-8602.1000167

Abstract

Acute Severe Ischemia Following Protected Distal Left Main Stenting for Recurrent Drug-Eluting Instent Restenosis: A Potential New Mechanism for Side-Branch Ischemia

Left main coronary artery instent restenosis can be treated by repeat percutaneous intervention with drug-eluting stent. We report a 53- year old patient with protected left main disease who presented with recurrent drug-eluting instent restenosis of distal left main/left circumflex ostium. The patient required treatment with a third layer of drug-eluting stent, using the single-stent approach. Acutely following the procedure, the patient developed severe angina associated with 2-mm ST segment depression in electrocardiographic leads V1-V4. Re-look angiography demonstrated a patent stent and normal appearance of the ostium of left anterior descending artery. Plain balloon dilatation of the three-layers of stent-struts across the left anterior descending artery ostium completely relieved the ischemia.

Keywords: Instent-restenosis left main disease; Drug-eluting stent

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