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Hypertension is the leading modifiable risk factor for global cardiovascular disease, responsible for an estimated 10.8 million deaths and more than 200 million disability-adjusted life years annually.1 Despite the availability of effective pharmacological and lifestyle interventions, prevalence continues to rise, particularly in low- and middle-income countries (LMICs), where over three-quarters of all cases now occur.2 The condition’s […]

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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