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Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
10:28

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function

Published on: March 15, 2022

Transulnar sheathless percutaneous coronary intervention during bivalirudin infusion in high-risk elderly female with

Francesco Summaria1, Valerio Lucci, Marina Mustilli

  • 1Interventional Cardiology, Policlinico Casilino;

Heart International
|November 28, 2012
PubMed

Insights

Elderly patients with acute coronary syndromes (ACS) face high bleeding risks during percutaneous coronary intervention (PCI). This case study explores a sheathless PCI approach using bivalirudin in an 83-year-old woman with high bleeding risk.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Geriatric Medicine

Background:

  • Increasingly, elderly patients with acute coronary syndromes (ACS) undergo percutaneous coronary intervention (PCI).
  • Bleeding complications are common in ACS patients, significantly impacting prognosis and healthcare costs.
  • Periprocedural bleeding, especially in older adults, is linked to adverse clinical outcomes and increased mortality.

Observation:

  • An 83-year-old female presented with non-ST segment elevation myocardial infarction.
  • The patient had a high bleeding risk and an unsuitable radial artery for standard PCI.
  • She underwent a sheathless PCI procedure utilizing bivalirudin infusion.

Findings:

  • The sheathless PCI technique was successfully employed in a high-risk elderly patient.
  • Bivalirudin infusion was used as the anticoagulant during the procedure.
  • The case highlights the feasibility of alternative PCI approaches in complex patient profiles.

Implications:

  • This case demonstrates a potentially safer PCI strategy for elderly patients with elevated bleeding risks.
  • Sheathless PCI may reduce vascular complications and bleeding events in this vulnerable population.
  • Further research into sheathless techniques and anticoagulation strategies like bivalirudin is warranted for optimizing ACS management in the elderly.

Keywords:
acute coronary syndromebivalirudinelderlysheatless guiding catheter.transradial PCI

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