A Heart With 67 Stents

Rami N. Khouzam, Rajvir Dahiya, and Richard Schwartz

J. Am. Coll. Cardiol. 2010;56;1605
doi:10.1016/j.jacc.2010.02.077

This information is current as of December 5, 2010

The online version of this article, along with updated information and services, is
located on the World Wide Web at:
http://content.onlinejacc.org/cgi/content/full/56/19/1605

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

IMAGES IN CARDIOLOGY

A Heart With 67 Stents

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

A
From Winthrop University 56-year-old male with coronary artery disease presented with angina, nonspecific elec-
Hospital, Mineola,
New York. trocardiographic changes, and elevated troponins. Coronary angiography revealed total
Manuscript received occlusion of a stent in the circumflex artery, where another was deployed— his 67th
January 29, 2010;
accepted February 16, 2010.
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 great
tool 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.

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 A Heart With 67 Stents
Rami N. Khouzam, Rajvir Dahiya, and Richard Schwartz
J. Am. Coll. Cardiol. 2010;56;1605
doi:10.1016/j.jacc.2010.02.077
This information is current as of December 5, 2010

Updated Information including high-resolution figures, can be found at:

& Services http://content.onlinejacc.org/cgi/content/full/56/19/1605
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