Severe acute coronary spasm following intracoronary radiation for in-stent restenosis: a case report.
Intracoronary radiation therapy is currently the only available treatment for the prevention of recurrence of in-stent restenosis. We report a case of severe coronary spasm after excimer laser angioplasty, balloon angioplasty, and intracoronary gamma radiation in the right coronary artery (RCA) that resulted in an acute myocardial infarction. Treatment with 600 microg of intracoronary nitroglycerin resulted in minimal improvement; therefore, diltiazem 400 microg was administered intracoronary with total resolution of the spasm, restoring normal coronary blood flow without trace of acute dissection or thrombus inside the artery.
Gruberg
L
L
Cardiac Catheterization Laboratory, Washington Hospital Center, Washington, DC 20010, USA. lxg6@mhg.edu
Waksman
R
R
D023903:Coronary Restenosis / Q000150:complications* / Q000532:radiotherapy*; D003329:Coronary Vasospasm / Q000188:drug therapy* / Q000209:etiology*; D004110:Diltiazem / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology*; D005996:Nitroglycerin / Q000627:therapeutic use*; D015607:Stents / Q000009:adverse effects*; D014665:Vasodilator Agents / Q000627:therapeutic use*
D014665:Vasodilator Agents; D004110:Diltiazem; D005996:Nitroglycerin