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31 yo man with #NSTEMI. Thrombotic+occluded RCA. This is what you get after 6 passages of #CatRx #Penumbra and POBA with 5.5 mm balloon. What do you do now? @ShariqShamimMD @AntoniousAttall @aspergian1 @mmamas1973 @perc_surgeon @Babar_Basir @DrAmirKaki @BElbarouni @chipkaminsky
What’s next?
After POBA with 5.5 mm 
we gave double bolus of eptifibatide — clot got fragmented and we passed from TIMI 0 to TIMI 2 flow. We kept the pt on ASA+cangrelor/prasugrel+heparin+eptifibatide for 24 hours. Here you can see the final result after the first procedure.
we gave double bolus of eptifibatide — clot got fragmented and we passed from TIMI 0 to TIMI 2 flow. We kept the pt on ASA+cangrelor/prasugrel+heparin+eptifibatide for 24 hours. Here you can see the final result after the first procedure.
This is 24 h after initial presentation: slightly improved situation. ‘Direct stenting’ with 3.5 and 4.0 mm stents postdil with 4.0 and 5.0 mm . #imagefirst shows grossly underexpanded stents (vessel was 6.5-7.5 mm!). Postdil with 5.5 at 30 atm. Better. Huge final MSAs.
. #imagefirst shows grossly underexpanded stents (vessel was 6.5-7.5 mm!). Postdil with 5.5 at 30 atm. Better. Huge final MSAs.
