We describe a patient suffering from late stent thrombosis in a paclitaxel-eluting stent which had an underexpanded ring due to the three-hundred-sixty-degree circumferential calcified plaque. Intravascular ultrasound...We describe a patient suffering from late stent thrombosis in a paclitaxel-eluting stent which had an underexpanded ring due to the three-hundred-sixty-degree circumferential calcified plaque. Intravascular ultrasound (IVUS) revealed rotational atherectomy could success-fully ablate both the metallic ring and the calcified ring. The ablated segment was scaffolded with a new paclitaxel-eluting stent, well ex-panded and documented by IVUS. To our knowledge, this is the first case report of stent ablation for an unexpanded paclitaxel-eluting stent. From the Medline index, there were only six case reports of stent ablation. We review and summarize the operation details of stent ablation from these reports.展开更多
Syncope and near syncope are great diagnostic challenges in medicine. On the one hand, the symptom may result from a benign condition and pose little or no t hreat to health other than that related to falling. On the ...Syncope and near syncope are great diagnostic challenges in medicine. On the one hand, the symptom may result from a benign condition and pose little or no t hreat to health other than that related to falling. On the other hand, syncope o r near syncope can be the manifestation of a serious underlying condition that poses an imminent threat to life. Patients with a cardiac cause of syncope are a t far greater risk of dying in the first year after an episode of syncope or nea r syncope than individuals with a noncardiac cause. A cardiac cause of syncope should be considered in every patient with syncope or near syn cope, but it is particularly common in older patients or in patients with known structural hear t disease, arrhythmia, or certain electrocardiographic abnormalities. Although m any diagnostic tests may be helpful in the evaluation of syncope and near synco pe, the history, physical examination, and electrocardiogram pinpoint the cause in many circumstances. Syncope after exercise may be due to left ventricular out flow tract obstruction from aortic stenosis or hypertrophic obstructive cardiomy opathy but can also suggest the diagnosis of postexercise hypotension in which a n abnormality in autonomic regulation of vascular tone or heart rate results in vasodilation or bradycardia after moderate intensity aerobic activity. The pati ent discussed in this case highlights the importance of the clinical history in the evaluation of this condition, since the diagnosis was revealed as the patien ts story was described and eventually acted out.展开更多
文摘We describe a patient suffering from late stent thrombosis in a paclitaxel-eluting stent which had an underexpanded ring due to the three-hundred-sixty-degree circumferential calcified plaque. Intravascular ultrasound (IVUS) revealed rotational atherectomy could success-fully ablate both the metallic ring and the calcified ring. The ablated segment was scaffolded with a new paclitaxel-eluting stent, well ex-panded and documented by IVUS. To our knowledge, this is the first case report of stent ablation for an unexpanded paclitaxel-eluting stent. From the Medline index, there were only six case reports of stent ablation. We review and summarize the operation details of stent ablation from these reports.
文摘Syncope and near syncope are great diagnostic challenges in medicine. On the one hand, the symptom may result from a benign condition and pose little or no t hreat to health other than that related to falling. On the other hand, syncope o r near syncope can be the manifestation of a serious underlying condition that poses an imminent threat to life. Patients with a cardiac cause of syncope are a t far greater risk of dying in the first year after an episode of syncope or nea r syncope than individuals with a noncardiac cause. A cardiac cause of syncope should be considered in every patient with syncope or near syn cope, but it is particularly common in older patients or in patients with known structural hear t disease, arrhythmia, or certain electrocardiographic abnormalities. Although m any diagnostic tests may be helpful in the evaluation of syncope and near synco pe, the history, physical examination, and electrocardiogram pinpoint the cause in many circumstances. Syncope after exercise may be due to left ventricular out flow tract obstruction from aortic stenosis or hypertrophic obstructive cardiomy opathy but can also suggest the diagnosis of postexercise hypotension in which a n abnormality in autonomic regulation of vascular tone or heart rate results in vasodilation or bradycardia after moderate intensity aerobic activity. The pati ent discussed in this case highlights the importance of the clinical history in the evaluation of this condition, since the diagnosis was revealed as the patien ts story was described and eventually acted out.
