It was reported that thrombosis, dissection, chest pain and st segment elevation occurred.The patient presented with restenosis after multiple layers of stents were placed a couple of months ago.Vascular access was obtained via the femoral artery.The target lesion was located in the mid left anterior descending artery (lad).After a 3.5mm non-bsc guide wire and another non-bsc wire were used to cross the lesion, an emerge balloon catheter was advanced for dilatation.A 3.00 x 16mm synergy ii drug-eluting stent was implanted in the mid lad.A 3.0x12mm nc quantum balloon catheter was advanced for post dilatation but the device failed to cross.A 3.0x12mm non-bsc balloon was advanced and post dilation was performed and the stent looked fine.The patient went to recovery.However, a dissection was noted in the brachial area.Twenty to thirty minutes post stent deployment, st elevation and chest pain was experienced by the patient and was put back on the table.Vascular access was obtained via the left groin.A 3.5mm non-bsc wire and another non-bsc wire were used.Thrombosis was noted in proximal lad to distal area.The lad was wired and ballooned and the flow was restored.Additional stent was implanted to cover the dissection with timi 3 flow post procedure.Patient was unstable with low blood pressure and atrial fibrillation.The patient was placed on three pressures, synchronized cardioverted.The patient was transferred to cardiovascular intensive care unit in critical condition.Patient was still conscious and alert on bilevel positive airway pressure.No further patient complications reported and the patient was stable.
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