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Complete or Partial Revascularization During Emergency PCI in a Patient With NSTEMI
Shengjia Sun1, Alimujiang Maimaitijiang1
1Department of Cardiovascular Disease, Huashan Hospital, Shanghai, China.
Background:
Optimal management of nonculprit lesions remains uncertain in patients with non-ST-segment elevation myocardial infarction (NSTEMI) during emergency percutaneous coronary intervention (PCI).
Case Summary:
An NSTEMI patient underwent emergency PCI for electrocardiogram-indicated culprit lesion only. His nonculprit lesion progressed to asymptomatic total occlusion in 5 days despite medical therapy.
Discussion:
This case highlights that in NSTEMI patients: 1) symptom resolution does not guarantee lesion stability; 2) complete revascularization should be considered for all unstable lesions during emergency PCI; and 3) intravascular imaging is useful to help identify unstable lesions during emergency PCI.
Take-Home Message:
Combine all symptoms, electrocardiographic findings, angiographic characteristics, and intravascular imaging to help identify and treat unstable lesions during emergency PCI in NSTEMI patients.
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