Objectives-The aim of this study was to assess the pharmacokinetics and tolerability of Biolimus A9 eluted from Nobori coronary stents.Background-The release kinetics and pharmacokinetics of drugs delivered via coronary stents have been shown to play an essential role in the efficacy and safety of drug eluting stents.
Serbia's interventional community has been facing the multifaceted challenge of an ageing population with cardiovascular diseases as the primary cause of death nationwide, coronary artery disease (CAD) being the most prevalent subset. The following two fields of activity have marked the trajectory of progress in the field of interventional cardiology in Serbia: first, the expansion of the infrastructure, mainly through the opening of new catheterisation laboratories across all of the country's administrative regions, which has resulted in better accessibility to coronary interventions for the general population; second, the creation of national platforms for continuous education, training and the promotion of clinical research in interventional cardiology, with close programmatic links to European Association of Percutaneous Cardiovascular Interventions (EAPCI)-based educational initiatives, including the curriculum for interventional cardiology. As growth seems to be inherent to the concept of progress, we report here on the expanding numbers of coronary interventions in the period between January 2010 and December 2015, and the early experiences with structural heart interventions in Serbia.
Introduction. Congenital coronary anomalies are detected in around 5% of all
performed coronarographies. Coronary artery anomalies considered as those of
great risk are the ones arising from the opposite sinus of Valsalva. These
anomalies are detected in around 1% of cases. This case report shows a unique
case of a patient with anterior wall STEMI caused by left main coronary
artery (LMCA) occlusion which arises from the right coronary cusp and has
interarterial course, which was successfully treated with primary PCI. Case
Report. A 46-year-old male patient was admitted to the hospital due to STEMI
of the anterior region. At the admission the patient was hypertensive
(150/100 mmHg) in sinus rhythm (heart rate around 70/min), Killip I. After
the initial examination and admitting dual antiplatelet therapy, the patient
was transferred for urgent coronarography. Coronarography was performed by
using the trans-radial approach. The right coronary artery had no significant
stenosis and it was easily cannulated, whereas the left coronary artery could
not be cannulated at the usual position. The operator attempted to cannulate
the left coronary artery with multiple catheters of various curves,
unsuccessfully. The conclusion was that there was a coronary artery anomaly,
and the cannulation of the anomalous aortic origin of the left coronary
artery (AAOLCA) which arises from the opposite right coronary cusp, was
successfully performed with a Multipurpose catheter. Moreover, the left
coronary artery was occluded in the distal segment. Two drug-eluting stents
were implanted and followed by the development of no-reflow phenomenon and
cardiogenic shock. After the stabilization, CT coronarography was performed
and AAOLCA with an interarterial course was registered. During the follow-up
period SPECT was performed and in the staged procedure, the stent was
implanted on the proximal Cx, by using the TAP technique. Conclusion.
Patients with STEMI and the anomalies of coronary arteries are very rare. As
such, these patients represent a great challenge for revascularization.
Possessing the knowledge of anatomic varieties is paramount when it comes to
these patients, to treat them adequately with primary percutaneous coronary
intervention.
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