heart with 67 stents

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doi:10.1016/j.jacc.2010.02.0772010;56;1605J. Am. Coll. Cardiol.

Rami N. Khouzam, Rajvir Dahiya, and Richard SchwartzA Heart With 67 Stents

This information is current as of October 26, 2010

http://content.onlinejacc.org/cgi/content/full/56/19/1605located on the World Wide Web at:

The online version of this article, along with updated information and services, is

by on October 26, 2010content.onlinejacc.orgDownloaded from
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IMAGES IN CARDIOLOGY

A Heart With 67 Stents

Rami N. Khouzam, MD, Rajvir Dahiya, MD, Richard Schwartz, MDMineola, New York

From Winthrop UniversityHospital, Mineola,New York.Manuscript receivedJanuary 29, 2010;accepted February 16, 2010.

A56-year-old male with coronary artery disease presented with angina, nonspecific elec-trocardiographic changes, and elevated troponins. Coronary angiography revealed total

occlusion of a stent in the circumflex artery, where another was deployedhis 67th

stent. The patient had 28 catheterizations over 10 years, with stents placed in his native coro-

nary arteries as well as in 3 bypass grafts. All stents were placed to relieve his angina, refractory

to maximal medical treatment and transmyocardial laser revascularization. Stents can be a greattool to help revascularization and relieve symptoms; unfortunately, they are prone to thrombo-

sis and restenosis. If they fail while medical management is maximized unsuccessfully, alterna-

tive tools are lacking. This case raises many questions: How much is too much? Are there

guidelines? and What else can be offered for symptom relief? More studies are needed to

evaluate impact on quality of life versus risks in this multistent population. LAD

left ante-rior descending coronary artery; LCX left circumflex coronary artery; OM obtuse mar-

ginal branch of the circumflex coronary artery; RCA right coronary artery.

Journal of the American College of Cardiology Vol. 56, No. 19, 2010 2010 by the American College of Cardiology Foundation ISSN 0735-1097/$36.00Published by Elsevier Inc. doi:10.1016/j.jacc.2010.02.077

http://content.onlinejacc.org/http://content.onlinejacc.org/http://content.onlinejacc.org/http://content.onlinejacc.org/


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doi:10.1016/j.jacc.2010.02.0772010;56;1605J. Am. Coll. Cardiol.

Rami N. Khouzam, Rajvir Dahiya, and Richard SchwartzA Heart With 67 Stents

This information is current as of October 26, 2010

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heart with 67 stents

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