Coronary Dissection, No Flow, Cardiac Arrest

CASE REPORT, July 2011, VOL I ISSUE IV, ISSN 2042-4884
10.5083/ejcm.20424884.41 , Cite or Link Using DOI
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Arunkumar Panneerselvam, Prabhavathi Bhat, Manjunath Cholenahally Nanjappa

ABSTRACT

Coronary angioplasty with stenting is a safe procedure in experienced hands. Anticipating and tackling complications is the key to successful coronary intervention. We present a 63-year-old man with unstable angina, who underwent angioplasty and stenting to left anterior descending artery. A dissection was noted at the distal end of the stent and this was covered with another stent.

Following stenting another dissection was noted distal to the second stent and a third stent was deployed. Subsequently, there was no-flow and patient had a cardiac arrest from which he was resuscitated. Finally TIMI III flow was achieved and further in hospital course was uneventful. Dissection, no flow and cardiac arrest are the dreaded complications of angioplasty and all three occurred in this patient. Steps to prevent these complications and management options are discussed.

INTRODUCTION

Percutaneous transluminal coronary angioplasty (PTCA) is the treatment of choice for high risk unstable angina. Though PTCA is a safe procedure complications are not uncommon. We describe a patient who developed complications that were recognised and managed appropriately.