Abstract
Optimal management of multivessel coronary artery disease can be complex. We report a 67-year-old male patient who was admitted to the Padua University Hospital, Padua, Italy, in 2014 with a non-ST-elevation myocardial infarction. Coronary angiography showed diffuse multiple sub-occlusive lesions of the proximal and distal left coronary vessels involving a long segment of the vessel. On intravascular ultrasonography (IVUS), the left main artery was moderately diseased with critically stenotic and calcified branch ostia. A successful percutaneous coronary intervention using the T-stenting and small protrusion technique with two drug-eluting stents (DES) was performed on the left main artery and its main branches. Two bioresorbable vascular scaffolds were also deployed in overlap at the mid to distal segments of the left anterior descending artery and overlapping a previous DES at the proximal segment. The full expansion and apposition of the struts and scaffolds to the vessel wall without residual stenosis was confirmed by IVUS.
Highlights
We report a 67-year-old male patient who was admitted to the Padua University Hospital, Padua, Italy, in 2014 with a non-ST-elevation myocardial infarction
Coronary artery bypass grafting (CABG) surgery and percutaneous coronary intervention (PCI) are potential treatment options for patients with advanced coronary artery disease (CAD) evaluated using the SYNTAX score, as stated in the European Society of Cardiology and the European Association for Cardio-Thoracic Surgery guidelines on myocardial revascularisation.[2]. This case describes a patient with multivessel CAD who was treated successfully with a combination of drug-eluting stents and bioresorbable vascular scaffolds
One recent trial involving patients with diabetes mellitus and advanced multivessel CAD found that CABG treatment was beneficial in that it significantly reduced rates of death, myocardial infarction and repeated revascularisation at a five-year follow-up, a higher rate of strokes was observed.[6]
Summary
At a six month clinical follow-up, the patient was symptom-free
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