Key result
PCI with IABP and IVUS yields good mid-term outcomes in severe three-vessel disease after CABG refusal.
Case Report (n=1)
PCI with IABP and IVUS optimization can be successfully performed as an alternative to CABG in a diabetic patient with severe three-vessel and left main disease who refuses surgery.
Coronary artery disease (CAD) is known to be the main cause of morbidity and mortality in patients with diabetes mellitus. Although they do not often show typical recognized symptoms, diabetic patients suffer from more extensive CAD and hence higher incidence of multi-vessel CAD than in non-diabetic subjects. Literature has given the strength of evidence in favor of surgical revascularization in diabetic patients with multi-vessel disease. We report the case of a 61-year old active smoker and diabetic man with atypical symptoms and positive treadmill test. The coronary angiography revealed a severe three-vessel disease and distal left main involvement (SYNTAX score = 49). As the patient refused to follow heart team indication to undergo coronary bypass grafting, a percutaneous coronary intervention was successfully performed with intra-aortic balloon counterpulsation support and intravascular ultrasound optimization. The mid-term outcome was good.
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Boukhris et al. (2014) conducted a case report in Coronary artery disease (n=1). Percutaneous coronary intervention with intra-aortic balloon counterpulsation support and intravascular ultrasound optimization vs. Coronary bypass grafting (refused) was evaluated on Mid-term outcome. PCI with intra-aortic balloon counterpulsation and IVUS optimization yielded a good mid-term outcome in a 61-year-old diabetic man with severe three-vessel disease who refused CABG.
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