Patient had 3 non medtronic stents implanted to the ostium of the svg-d-om bypass (b)(6) 2004.On (b)(6) 2007 the patient returned with unstable angina that required deployment of a non medtronic stent to treat the ostium of the svg-d-om bypass for the first episode of in-stent restenosis.On (b)(6) 2008 the patient was admitted with unstable angina and diagnosed with a second episode of ostial svg-d-om bypass graft in-stent restenosis.During revasc procedure, an endeavor zes was implanted to treat restenosis.The stent was deployed at 16atm for 25 seconds and post-dilated at 21 atm for 30 seconds with 0% post-procedure stenosis.85 days later ((b)(6) 2018) post implant of endeavor rx drug eluting stent, the patient was re-admitted with chest pain and a non stemi.Total occlusion was noted of the previously treated svg-d-om bypass with total occlusion and evidence of proximal fracture in a highly dynamic portion of the vessel.2 sprinter balloons were used to dilate the area of instent restenosis distal to the stent fracture and the proximal stent fracture area itself.The guidewire, balloon and guide catheter were removed together restoring of thrombolysis in myocardial infarction (timi flow 3) in the bypass graft.The proximal section of the fractured stent was reported to have dislodged at the femoral artery sheath level.Vascular surgery evaluation located the dislodged fragment in a branch of the right femoral profundis artery.It was decided to leave the stent fragment in the femoral profundis branch.The patient recovered without any issue and discharged from hospital 2 days later.
|