A Rare Case of Radial Arteriovenous Fistula (AVF) Post-Transradial Percutaneous Coronary Intervention.

We report a rare case of radial arteriovenous fistula in a middle-aged person after a successful transradial percutaneous coronary intervention. Early release of manual radial compression was the culprit behind the development of radial arteriovenous fistula. Early surgical repair of the radial arteriovenous fistula resulted in the complete resolution of distal forearm symptoms in the abovementioned patient. It is advised for young interventional cardiologists to apply a compressive bandage over the radial artery for a minimum period of one hour to get rid of this extremely rare complication.

The Closure of Grade 1 Coronary Perforation by the Snowplow Phenomenon.

We report an extremely rare case of spontaneous closure of grade 1 coronary perforation by the snowplow phenomenon during the revascularization of a subtotal occlusion in the left anterior descending coronary artery. Coronary artery perforation is usually a nightmare during coronary intervention in the cardiac catheterization laboratory. While large coronary perforation requires the deployment of a covered stent, small perforations require heparin reversal, prolonged balloon inflation, deployment of small coils, or gel foam closure. The coronary segment with a small perforation was stented with a drug-eluting stent (DES), which might have resulted in the shifting of the fatty plaque toward the perforation and subsequently sealing the coronary perforation.

The Rescuing Role of Aggressive Thrombosuction in Elective Coronary Angioplasty.

Thrombosuction plays a controversial role during primary percutaneous intervention (PCI). Landmark trials have demonstrated no additional role of thrombosuction during primary percutaneous intervention towards improving mortality and outcome during primary percutaneous intervention. We describe a rare elective coronary angioplasty where only aggressive thrombosuction (almost 150-200 mL) of blood from the coronary artery established the antegrade coronary flow and saved an octogenarian from impending sudden cardiac death (SCD). The present case describes the promising role of aggressive thrombosuction even during elective coronary intervention when a large dissection ends in acute total thrombotic occlusion of a coronary artery jeopardizing the antegrade coronary perfusion.