IJCS | Volume 32, Nº2, May/June 2019

299 Figure 2 - Coronary angioplasty of left anterior descending artery. A: occlusion in the medial third of the left internal thoracic artery; B: stenosis of the medial third of anterior descending artery; C: stent positioning in the stenosis; D: final result in the left anterior descending artery. Falcão et al. Coronary angioplasty with bleeding Int J Cardiovasc Sci. 2019;32(3)297-301 Case Report Here we report a case of a 42 year old woman with risk factors for cad other than the age, such as diabetes mellitus and hypertension. In light of the epidemics of obesity, it is expected an earlier onset of cardiovascular diseases in women. Therefore, the association of CAD with estrogen-dependent diseases will be more common. CAD is one of themain causes of mortalityworldwide. Revascularization (PTCA or surgical revascularization) is indicated for patients with stable disease, refractory to clinical treatment, or with acute coronary syndromes. The choice of treatment depends on the analysis of several factors, such as severity of CAD, surgical risk and risk of bleeding. 2 PTCA has a lower risk of bleeding, but requires antiplatelet therapy. High bleeding risk patients that require PTCA is a challenge. The risk of ischemia should always be evaluated together with the risk of bleeding, and the selection of both the stent type and the antiplatelet therapy regimen depends on such evaluation. 4 In the case reported, although the coronary stenosis was not complex, the patient was submitted to a surgical procedure. The choice was made because dual antiplatelet after this procedure was not necessary and hysterectomy was already schedule. Dual antiplatelet therapy is mandatory after stent implantation and recommended to be maintained until