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.
Acute coronary syndrome, bivalirudin, elderly, transradial PCI, sheatless guiding catheter.
Francesco Summaria, Interventional Cardiology, Policlinico Casilino, via Casilina 1049, 00169 Rome, Italy. E-mail: f.summaria@gmail.com
2012-01-21

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