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The first-in-human implantation of a leadless pacing system occurred already more than 10 years ago.1 The first-generation ventricular leadless pacemaker could provide only asynchronous ventricular pacing (ventricular, ventricular, inhibited [VVI], or ventricular, ventricular, inhibited, rate response [VVIR]), limiting its indications to patients with atrial fibrillation and severe bradycardia, those precluded for implantation of a transvenous pacemaker […]

Transulnar sheathless percutaneous coronary intervention during bivalirudin infusion in high-risk elderly female with non-ST segment elevation myocardial infarction

Francesco Summaria, Valerio Lucci, Marina Mustilli
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Published Online: Aug 7th 2018 Heart International 2012;7(2):e10 DOI: https://doi.org/10.4081/hi.2012.e10
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Abstract

Overview

Due to the ageing population and raised life
expectancy, elderly patients are increasingly
referred for percutaneous coronary intervention
(PCI) during acute coronary syndromes
(ACS). Bleeding complications are not infrequent
during ACS, occurring in 2-5% of
patients with prognostic and economic consequences.
In particular, periprocedural bleeding
and vascular complications are associated
with worse clinical outcome, prolonged hospital
stay and increased short- and long-term
mortality, especially in elderly patients with
acute coronary syndromes. We report the case
of an 83-year old female referred to our hospital
because of non-ST segment elevation
myocardial infarction with high bleeding risk
and unsuitable radial artery undergoing transulnar
sheathless PCI during bivalirudin infusion.
The clinical, technical, pharmacological
and prognostic implications are discussed.

Keywords

Acute coronary syndrome, bivalirudin, elderly, transradial PCI, sheatless guiding catheter.

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Article Information

Correspondence

Francesco Summaria, Interventional Cardiology, Policlinico Casilino, via Casilina 1049, 00169 Rome, Italy. E-mail: f.summaria@gmail.com

Received

2012-01-21

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