[Late stent thrombosis in a young patient who had ulcerative colitis]

Arterial and venous thrombosis are well recognized systemic complications of inflammatory bowel disease predominantly in patients with Crohn's colitis and in those with ulcerative colitis [UC]. report a new case We describe the case of a 35 years old man presenting previously an anterior infarct with a tighten stenosis in the middle part of the left anterior descending artery [LAD]. The stenosis was treated percutaneously with a bare stent deployment. During an acute exacerbation of UC, the patient developed an acute coronary syndrome with ST elevation secondary to a late stent thrombosis, needing a primary coronary angioplasty. Following course is favorable. Based on this case, we'll discuss the relationship between UC and thrombosis, and therapeutic considerations inherent to thrombotic and bleeding risks

Rdial access for concomitant coronary, subclavin and renal artery angioplasty: one case report]

Concomitant coronary and peripheral angioplasty is a more frequently reported situation. Patient's outcome is significantly conditioned by access site complications especially in femoral and brachial approaches. The radial artery access is a safe and a well established alternative in coronary interventions and could be suitable for many peripheral angioplasty cases, thanks to devices enhancement. Rport a new case. We report the case of a 56-year-old woman with multivessel coronary artery disease, significant left subclavian [SCA] and bilateral renal arteries stenoses. Because of a severe resistant hypertension and prior to scheduled coronary bypass surgery a triple angioplasty of left renal artery, SCA, and left anterior descending [LAD] was attempted. Stenting of the three sites was successful in the same procedure through the left radial artery route. Radial artery access in peripheral, combined and complex percutaneous transluminal angioplasty seems to be suitable and safe. However, prospective clinical trials are still lacking

[Assessment of endothelial function reliably predicts the existence and the severity of coronary disease]

Endothelial dysfunction has been proven to be. a cornerstone of atherosclerosis occurrence, development and progression. However, its use in clinical practice is still unclearly defined, this study was to prospectively assess how accurately endothelial function assessment predicts the existence and the extensiveness of significant coronary artery disease. Fifty adults [37 men and 13 women, mean age of 59.9 +1-12.6 years] were randomly included among candidates for a coronary angiography. They previously underwent endothelial function assessment by the Flow-mediated dilation technique [FMD] according to ACC guidelines. The FMD%was expressed as maximal percent change in brachial artery diameter from baseline and the test was considered positive when FMD%was below 5%. Endothelial function impairment has been diagnosed in 36 patients and at least one significant coronary artery stenosis [>50%] in 38 patients. Endothelial dysfunction predicted significant coronary stenosis with a sensibility and a specificity of 89.5%and 83%respectively; positive predictive and negative predictive values were 94.4%and 71.4%respectively. Statistical correlation has been found between FMD%and the number of significantly diseased coronary vessels [rs-0.44; p=0.001].An FMD%less than 8%reliably predicted all multivessel coronary-diseased patients. In multivariate analysis, endothelial dysfunction was the only independent predictive factor of coronary disease [p=0.02]. Endothelial dysfunction has been proven to be highly correlated to the existence of significant coronary stenosis at coronary angiography [PPV=94 .4%]. The severity of endothelial dysfunction assessed by the FMD%has also been significantly correlated to the extensiveness of coronary disease

torsade de pointes a couplage court: Notre experience et revue de la litterature.

We present three cases of short-coupled variant of torsade de pointes with review of the literature. These women presented with syncope or presyncope due to torsade de pointes initiated by a short-coupled premature ventricular beat and without evidence of prolonged QT. There were no electrolyte disturbances in all cases, no apparent structural heart disease in two cases and a mild interventricular septum hypertrophy in the other case. One patient took spiramycin and metro nidazole and another was taking pheniramin and lincomycin without any evidence of cause to effect relationship. One patient responded to verapamil but died suddendly after 44 months of follow-up. The two others. Received implantable cardioverter-defibrillators and verapamil per os. They still alive 46 and 54 months later. Short-coupled variant of torsade de pointes have a high incidence of sudden death, so it is very important for physicians to identify and treat it promptly, long-term verapamil treatement is effective but still insufficient and patients should be considered for implantable cardioverter-defibrillator therapy