Simultaneous Stent Thrombosis In Rca and Lad Treated with Simultaneous Radial and Femoral Approaches

Abstract

Staged percutaneous coronary intervention of a non-culprit vessel after treatment of the culprit vessel is common practice and has been found to be beneficial in small-randomized controlled trials and observational studies. There is a high risk of stent thrombosis within the first 30 days after stent implantation. Staged percutaneous coronary intervention of a non-culprit vessel is sometimes necessary within the first 30 days of primary percutaneous coronary intervention and is commonly performed but such procedures may be associated with a risk of simultaneous stent thrombosis in the implanted stents. Here we describe a patient who presented with inferior ST elevation myocardial infarction and had percutaneous coronary intervention of the culprit vessel, the right coronary artery, followed by staged percutaneous coronary intervention of left anterior descending artery. One week later the patient presented with simultaneous stent thrombosis in both the right coronary artery and left anterior descending artery. He was then treated with simultaneous percutaneous coronary intervention of left anterior descending and right coronary artery via the right femoral and right radial approach to minimize time to restore flow in both the vessels.