A case of myocardial infarction not to be stented too quickly

Abstract

This is a case of an interventional dilemma about how to manage a large thrombus, located distally from and adherent to a severe stenosis in a coronary venous bypass graft, with a TIMI-3 flow in a patient with a non-ST-elevation myocardial infarction. This case report concerns a 70-year-old female patient, diagnosed with unstable angina, 18 asymptomatic years after coronary bypass surgery. Although a high risk of a severe ischaemic event is present, immediate coronary intervention is not mandatory since perfusion is maintained, and given the real risk of embolisation of the large thrombus, even contra-indicated. From this perspective, the option to bail out and install an extensive antithrombotic therapy prior to delayed intervention is reasonable.

Framing Communication Infrastructures (1950–2020). Discours et imaginaires / Diskurse und Vorstellungen

“…Radio represented a possible answer to the problem: "[…] broadcasting emerges as a method both cheap and efficient […] when boldly and skillfully handled, broadcasting remains the most expeditious method of bringing to great numbers of people that body of knowledge without which they are unable to take their place as useful citizens of a modern state." 43 Halls even posits that, since Pakistani villagers communicated "by word of mouth rather than by the written word," broadcasting "follows a tradition of instruction which must be more acceptable, in the early stages, than through any other medium." 44 Because of the limited duration of the mission, Halls agreed with the staff at Radio Pakistan, the national broadcasting service, that the scope should be limited to schools broadcasting.…”