Effects of intracoronary nicardipine, diltiazem and verapamil on coronary blood flow.

Background: Intracoronary (IC) calcium channel blockers (CCB) such as diltiazem and verapamil are frequently utilized during percutaneous coronary interventions to maximize coronary blood flow. Their use, however, may be limited by systemic side effects such as hypotension and bradyarrhythmias. The vasoselective dihydropyridines, such as nicardipine, may be more effective at increasing coronary blood flow with fewer systemic side effects.

Emergency intravascular ultrasound to locate a stent during primary angioplasty.

A 62-year-old man underwent primary PTCA with bail-out stent placement for an acute anterior wall myocardial infarction. After initial deployment of one half of a Palmaz-Schatz stent, the stent could not be visualized fluoroscopically. Emergency intravascular ultrasound (IVUS) showed the stent to be located proximal to the intended site of deployment.