Bare metal or drug-eluting stent implantation in last remaining vessel PCI? A serious dilemma.
This case report describes the treatment of an old male diabetic patient with last remaining vessel coronary artery disease and poor left ventricular function. In presence of an old occlusion of the left main coronary artery, a subtotal stenosis of a dominant right coronary artery required angioplasty. After ample consideration it was decided to implant a bare metal stent (BMS) instead of a drug-eluting stent (DES). The major reason was the fear for early discontinuation of clopidogrel in case a drug-eluting stent was placed. The procedure and follow-up are described followed by an overview of current literature concerning similar pathology.
Zhang
Lei
L
Department of Cardiology of the First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, People's Republic of China.
Zhu
Jianhua
J
Kiemeneij
Ferdinand
F
D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000601:surgery*; D003657:Decision Making; D054855:Drug-Eluting Stents; D006801:Humans; D008297:Male; D012720:Severity of Illness Index