Case 24 - 52 y.o. male, acute myocardial infarction, Crushed Stent

This is a 52 year old male. Two months ago he had an acute myocardial infarction of the inferior wall. Cardiac catheterization revealed a mid-RCA occlusion and he was treated with a 3 mm GFX stent. He subsequently did well until two hours prior to 2^nd catheterization when he presented with recurrent ischemic symptoms. He was given tirofiban in the ED.

Procedure

1. IVUS 40 MHz
2. Mid RCA: 3.0 mm balloon,16 atm
3. Proximal RCA: 3.0 mm balloon, 8 atm
4. Proximal RCA: Stent (Duet), 3.0 x 13 mm,12 atm
5. Proximal RCA: 3.5 mm balloon,12 atm
6. IVUS
7. Mid RCA: Stent (Duet), 3.5 x 8 mm,14 atm
8. IVUS

View the IVUS video: Pre-Intervention, Previous Stented Lesion

View the IVUS video: Pre-Intervention, Culprit Lesion

View the IVUS video: Post-POBA to the In-Stent Restenosis

View the IVUS video: Post-Stent to the Culprit Lesion

View the IVUS video: Post-Stent to Cover the Crushed Stent

(Requires Apple Quicktime Plug-in, available to download free form the Apple Quicktime site, Quicktime 3.0 with 2.0 plug-in recommended)

View the Angiography & IVUS still images

 

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