Concurrent coronary, bilateral iliac and left renal artery direct stenting.

We describe a patient who underwent percutaneous coronary intervention combined with bilateral iliac and left renal artery angioplasty during the same sitting. Stenting of the coronary and peripheral arteries was performed employing the "direct stenting" technique. No complications occurred. The patient was discharged 2 days after the intervention and remains asymptomatic, leading a fully active life during 1 year of follow-up. To our knowledge, unstaged coronary stenting combined with direct stenting of the renal and both common iliac arteries has not been reported previously in India.

Coronary stenting without pre-dilatation: an observational study.

Conventional coronary stenting is done after pre-dilatation of the lesion. The bleeding complications and incidence of subacute stent thrombosis have been reduced significantly by the use of antiplatelet agents and high pressure balloon inflation to ensure complete stent expansion. Elective stenting also can be done without pre-dilatation by "stent alone technique." This approach significantly reduces the procedural cost and ischaemia time, avoiding potential complications such as abrupt vessel closure because of extensive dissection after conventional angioplasty and prior to stent deployment. Eighty patients of stable angina pectoris suitable for coronary angioplasty underwent stenting without pre-dilatation. Out of the 100 stents used, 38 were hand-crimped and 62 were pre-mounted. The target vessels were left anterior descending artery in 56 percent, right coronary artery in 32 percent and left circumflex in 12 percent. The procedure was successful in 88 percent lesions. In 12 percent stenting could be done only after pre-dilatation. In all these, there was proximal tortuosity and calcification. The fluoroscopy time was 10.2 +/- 4.5 minutes. The average number of balloons used per lesion was 1.08. Stent embolisation occurred in only one patient. There were no major adverse cardiac events in any of the patients. Thus stenting without pre-dilatation is safe. Patients who are eligible for stenting without pre-dilatation are those with stable angina pectoris without fluoroscopically visible calcium or coronary artery tortuosity and with lesions of moderate complexity.

Elective coronary artery stenting--immediate and follow up results.

Elective coronary artery stenting was performed in 242 consecutive patients in our centre for complex lesions (Type B, C), proximal lesions, restenotic lesions, total occlusion and venous grafts. The procedural success rate was 94.21%. Three patients (1.23%) required emergency coronary artery bypass surgery. Acute and sub-acute thrombosis rate was 1.26% and 4.13%, respectively. There was one in-hospital death (0.41%). 164 patients were followed up clinically for a mean period of 11 +/- 6 months (range 1 month to 30 months). Angiographic follow up was done in 68 patients with a restenosis rate of 16.17%.

Tricuspid valve endocarditis following elective abortion.

Tricuspid valve endocarditis (TVE) following non-septic abortion without an evidence of pelvic inflammation and clinically audible murmur is rare. We report here two cases of TVE following elective abortion.