Elective Percutaneous Coronary Intervention Performed During Contrast-Induced Hypotension

Objectives: To demonstrate the feasibility and safety of performing percutaneous coronary intervention (PCI) during contrast reaction producing severe hypotension.Background: The development of profound hypotension due to a contrast reaction usually signals procedure termination. Methods and Results: We report successful completion of planned PCI with blood pressure support with vasopressors during contrast-induced hypotension in 9 procedures in 3 patients with previously known contrast reaction. Conclusions: This case series provides support for the feasibility and safety of performing successful planned PCI under blood pressure support in patients with contrast reaction causing severe hypotension. A management approach for considering intervention in the setting of contrast-induced hypotension is provided.

Alkylation, metalation and ring contraction of tropiporphyrin

Tropiporphyrins are an intriguing class of carbaporphyrinoids that incorporate a cycloheptatriene subunit. Previous investigations have shown that this system acts as a trianionic ligand that can form stable silver(III) complexes. In this work, tropiporphyrin was reacted with excess methyl iodide and potassium carbonate in refluxing acetone to give an internally alkylated derivative. The reaction occurred regioselectively to introduce a methyl group onto the 24-position. Reaction with palladium(II) acetate afforded a palladium(II) complex that retained the [Formula: see text]-methyl substituent. In contrast, reaction of [Formula: see text]-unsubstituted tropiporphyrin with palladium(II) acetate gave two palladium(II) benziporphyrins, one of which possessed a formyl substituent. Although these organometallic derivatives were obtained in relatively low yields, the observation of unexpected ring contraction products demonstrates that the reactivity of the tropiporphyrin system deserves to be further investigated.