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A Heart With 67 Stents Rami N. Khouzam, Rajvir Dahiya, and Richard Schwartz J. Am. Coll. Cardiol. 2010;56;1605 doi:10.1016/j.jacc.2010.02.

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This information is current as of October 26, 2010

The online version of this article, along with updated information and services, is located on the World Wide Web at: http://content.onlinejacc.org/cgi/content/full/56/19/1605

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Journal of the American College of Cardiology 2010 by the American College of Cardiology Foundation Published by Elsevier Inc.

Vol. 56, No. 19, 2010 ISSN 0735-1097/$36.00 doi:10.1016/j.jacc.2010.02.077

IMAGES IN CARDIOLOGY

A Heart With 67 Stents


Rami N. Khouzam, MD, Rajvir Dahiya, MD, Richard Schwartz, MD Mineola, New York

From Winthrop University Hospital, Mineola, New York. Manuscript received January 29, 2010; accepted February 16, 2010.

56-year-old male with coronary artery disease presented with angina, nonspecic electrocardiographic changes, and elevated troponins. Coronary angiography revealed total occlusion of a stent in the circumex artery, where another was deployed his 67th stent. The patient had 28 catheterizations over 10 years, with stents placed in his native coronary arteries as well as in 3 bypass grafts. All stents were placed to relieve his angina, refractory to maximal medical treatment and transmyocardial laser revascularization. Stents can be a great tool to help revascularization and relieve symptoms; unfortunately, they are prone to thrombosis and restenosis. If they fail while medical management is maximized unsuccessfully, alternative tools are lacking. This case raises many questions: How much is too much? Are there guidelines? and What else can be offered for symptom relief? More studies are needed to evaluate impact on quality of life versus risks in this multistent population. LAD left anterior descending coronary artery; LCX left circumex coronary artery; OM obtuse marginal branch of the circumex coronary artery; RCA right coronary artery.

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A Heart With 67 Stents Rami N. Khouzam, Rajvir Dahiya, and Richard Schwartz J. Am. Coll. Cardiol. 2010;56;1605 doi:10.1016/j.jacc.2010.02.077 This information is current as of October 26, 2010
Updated Information & Services Rights & Permissions including high-resolution figures, can be found at: http://content.onlinejacc.org/cgi/content/full/56/19/1605 Information about reproducing this article in parts (figures, tables) or in its entirety can be found online at: http://content.onlinejacc.org/misc/permissions.dtl Information about ordering reprints can be found online: http://content.onlinejacc.org/misc/reprints.dtl

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