Successful drug-coated balloon angioplasty and single anti-platelet therapy to treat an ischaemic stroke patient with haemorrhage and acute coronary syndrome.

A 55-year-old male presented with two challenging problems, i.e. acute coronary syndrome (ACS) and a major bleeding episode. He first presented with ischaemic stroke and was treated with thrombolysis. However this was complicated by haemorrhagic transformation. He subsequently developed ACS with urgent coronary angiography demonstrating a critical stenosis in the proximal left anterior descending artery. Percutaneous coronary intervention (PCI) was deemed necessary but we were mindful of causing bleeding complications from the use of anti-thrombotic therapy. Despite the complexities, we used a novel approach in terms of PCI strategy and anti-platelet regimen (drug-coated balloon angioplasty and a single anti-platelet therapy) and achieved a successful outcome.