Refractory vasospasm of the left anterior descending artery causing hemodynamic instability after percutaneous coronary intervention

Vilas Magarkar, Devendra Borgaonkar, Pravir Lathi


Refractory coronary vasospastic angina is prone to fatal outcomes. Therefore, it is crucial that the most suitable treatment strategy be promptly elected so as to avert further cardiac complications. Here, authors present the clinical course of profound refractory coronary vasospastic angina in a 50-year-old man. Authors elected to manage the patient through stent implantation. Despite, a complication of perforation followed by refractory coronary vasospasm, authors elected to implant a second stent to relieve the patient from all symptoms.


Coronary vasospasm, Drug-eluting stent, Percutaneous coronary intervention

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Kapoor JR, Price ET, Nijmeh JR, Williams SB. Multivessel coronary artery spasm and cardiac arrest following single vessel stenting. Intern J Cardiol. 2008 Sep 16;129(1):e35-6.

Nazir SA, Nazir S, Kumar S, Ilsley C. Multifocal severe coronary artery vasospasm mistaken for diffuse atherosclerosis: A case report. Case Rep Med. 2010;2010.

Jeong MH, Park JC, Rhew JY, Kang KT, Lee SH, Cho JH, et al. Successful management of intractable coronary spasm with a coronary stent. Japan Circul J. 2000;64(11):897-900.

Brott BC, Anayiotos AS, Chapman GD, Anderson PG, Hillegass WB. Severe, diffuse coronary artery spasm after drug-eluting stent placement. J Invasive Cardiol. 2006 Dec;18(12):584.

Azar RR. Diffuse coronary spasm in a patient with a recent stent. JACC: Cardi Inter. 2010 Apr 1;3(4):459-60.

Shibutani H, Akita Y, Matsui Y, Yoshinaga M, Karakawa M. The potential hazard of drug-eluting stent-induced coronary vasospasm causing subacute stent thrombosis: a case report. BMC Cardi Dis. 2016 Dec 1;16(1):236.

Khan HR, Aslam S. Blocked Coronary Artery Due To Coronary Spasm Treated With Stent Insertion: A Sub-Optimal Result?. J Ayub Med Coll Abbottabad. 2017 Jan 25;29(1):142-4.

Hokimoto S, Tabata N, Sueta D, Akasaka T, Tsujita K, Sakamoto K, et al. The real-world prevalence of cardiovascular events related to coronary spasm after percutaneous coronary intervention. J Cardiol. 2016 Jul 1;68(1):20-8.