title: Simultaneous transradial coronary and renal in stent restenosis treatment in diabetic patient with NSTEMI complicated by hypertensive emergency.
abstract: The elderly diabetic patients are increasingly referred for percutaneous coronary interventions during acute coronary syndromes. A nonegligible proportion of this population includes the in stent restenosis as a possible cause of ischemic syndrome. This population accounts an higher risk of ischemic, bleeding and vascular complications affecting the periprocedural management, the length of hospital stay and also the prognosis. The improvement of strategies concerning site of access choice, antithrombotic drug and timing of interventional treatment have significantly reduced the incidence of complications. This paper reports the case of a 76 years-old diabetic female with a high bleeding risk, referred to our hospital because of NSTEMI complicated by pulmonary edema during hypertensive emergency. The patient had a simultaneous in stent restenosis both in left descending coronary artery and left renal artery, undergoing percutaneous transradial treatment during bivalirudin infusion. The clinical, technical, pharmacological and prognostic implications are discussed.
authors.affiliation: Interventional Cardiology. Policlinico Casilino Rome, Italy. f.summaria@gmail.com
authors.forename: Francesco
authors.initials: F
authors.lastname: Summaria
authors.forename: Roberto
authors.initials: R
authors.lastname: Patrizi
authors.forename: Enrico
authors.initials: E
authors.lastname: Romagnoli
authors.forename: Marina
authors.initials: M
authors.lastname: Mustilli
authors.forename: Adolfo
authors.initials: A
authors.lastname: Pagnanelli
mesh_terms: D054058:Acute Coronary Syndrome / Q000150:complications / Q000628:therapy*; D000368:Aged; D000800:Angioplasty, Balloon; D023903:Coronary Restenosis / Q000150:complications / Q000628:therapy; D003331:Coronary Vessels; D048909:Diabetes Complications / Q000628:therapy*; D057510:Endovascular Procedures; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications*; D062645:Percutaneous Coronary Intervention; D011654:Pulmonary Edema / Q000150:complications; D012077:Renal Artery; D012078:Renal Artery Obstruction / Q000150:complications / Q000628:therapy*; D015607:Stents