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Distal embolization during coronary intervention of thrombotic material resulting in compromised coronary flow is a common complication usually described in the context of invasive treatment of the acute ST-segment elevation myocardial infarction (STEMI). In our case we report distal embolization, presumably with calcified atherosclerotic plaque fragment. It occurred during elective percutaneous coronary intervention on subostial part of right coronary artery. Fortunately, this embolization did not compromise distal flow but it resulted in a significant de novo lesion of the right coronary artery crux. This lesion was uncrossable for dilatation balloons using a variety of different basic and advanced tools and techniques. Therefore, we decided to perform rotational atherectomy that enabled a successful percutaneous coronary intervention with stent implantation. more...

The loss of a stent during percutaneous coronary intervention (PCI) is a rare complication of the procedure. Multiple manoeuvres for the stent extraction exist, using a small balloon being a common one (2). This case report demonstrates the loss of stent in the proximal segment of the RCA whose extraction attempt with a small size SCB failed. The SCB was unable to cross through the stent and kept pushing the stent distally up until the target location where it successfully crossed through the stent. Subsequent dilatation with larger size balloons achieved full stent expansion at the target location. more...

Destructive thyroiditis is a self-limited disease characterized by acute release of preformed thyroid hormones. We present a patient with extremely rare acute painful thyroiditis after percutaneous coronary intervention (PCI) in acute myocardial infarction without ST-elevation. The acute onset of thyroid pain and increase of fT3, fT4 and parameters of inflammation were compatible with acute destructive thyroiditis. Such acute thyroiditis probably resulted from local inflammation induced by a large amount of iodine given to the patient via iodinated contrast media used during PCI. Because of the increasing number of patients referred to cardiac catheterization, invasive cardiologists should be aware of the potentially serious thyroid dysfunction that can result from iodinated contrast use. The aim of our paper is, in the light of the patient presented, to discuss the pathophysiology, clinical presentations, therapy and potential preventive measures in patients that develop thyroid dysfunction after PCI. more...