It was reported that removal difficulty, shaft break, and acute thrombosis occurred.
Vascular access was obtained via the femoral artery.
The 70% stenosed, 38mmx3.
5mm target lesion was located in a non-tortuous, mildly calcified right coronary artery.
Pre-procedure, the patient was given 300mg aspirin and 300mg clopidogrel.
Intra-procedure, the patient was given tirofiban.
Following pre-dilatation with a 3.
0x20mm non-bsc balloon, the stenosis remained at 50%.
A total of four stents were implanted in the right coronary artery, including a 4.
0x20mm synergy, 3.
5x32mm synergy (complaint in question), 3.
5x32mm synergy and a 3.
5x38mm non-bsc stent.
Post implant of the first 3.
5 x 32mm synergy ii des stent, the balloon catheter was difficult to remove from the stent and also became stuck in the guiding catheter.
The shaft of the balloon was also noted to be detached/separated.
Both the guiding catheter and stent balloon catheter were safely removed from the patient.
A new guiding catheter was used and the procedure was successfully completed.
Post procedure, the patient developed chest pain associated with dyspnea.
Electrocardiography was performed immediately which revealed sinus tachycardia and subtle changes of high side wall.
It appeared ventilator failure was imminent so the patient was immediately returned to the cath lab with suspected acute stent thrombosis.
There was appreciated thrombotic load, not occlusive.
No stent deformation was noted.
Further intervention was performed with intracoronary tirofiban and the patient is reported to be stable.
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