Key result
Staged culprit-first PCI enables successful complex bifurcation stenting in STEMI with cardiogenic shock.
Why the study?
The optimal approach to revascularization in acute patients with cardiogenic shock and STEMI involving the left main coronary artery remains to be clarified.
Case Report (n=1)
No
Infarct-related artery only revascularization followed by staged complete revascularization is a viable strategy for STEMI patients in cardiogenic shock.
We present the case of patient with ST elevation myocardial infarction in cardiogenic shock with primary percutaneous coronary intervention of Left anterior descending coronary artery and Left main coronary artery with staged complex procedure on Left anterior descending/Diagonal branch bifurcation in Culotte manner. This case shows that “the simpler, the better” approach of only infarct related artery revascularization may be applied in acute patients with cardiogenic shock and optimal clinical and hemodynamic response on revascularization and intra-aortic balloon pump. But, complete revascularization should be done in staged procedure and later, a control coronary angiography with intravascular ultrasound assistance is mandatory.
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Simić et al. (2019) conducted a case report in ST elevation myocardial infarction (STEMI) with cardiogenic shock (n=1). Primary PCI with staged complex bifurcational treatment (Culotte technique) was evaluated on Angiographic and clinical success. A staged approach of initial culprit-only primary PCI followed by complex bifurcation stenting with IVUS guidance was successfully performed in a patient with STEMI and cardiogenic shock.
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