| Acute multi-vessel coronary stent thrombosis. | |
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MedLine Citation:
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PMID: 18823736 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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Background: Coronary artery stent thrombosis is a rare but often fatal complication associated with percutaneous coronary intervention (PCI) using both bare-metal stents and drug-eluting stents. Although strict adherence to dual anti-platelet therapy (aspirin plus clopidogrel) minimizes this risk, stent thrombosis will still occur in rare patients, leading to acute, subacute, or late life-threatening acute coronary syndromes. Objectives: To present a rare case of acute stent thrombosis involving multiple vessels to increase awareness of this life-threatening condition among emergency physicians, and to review the current guidelines for anti-platelet therapy in this patient population. Case Report: A 52-year-old man who underwent PCI using drug-eluting stents in two separate coronary vessels presented to the Emergency Department within 2 h of discharge from the hospital with chest pain, dynamic electrocardiogram changes, and elevated cardiac markers. Despite compliance with the current recommendations for post-PCI anti-platelet therapy, urgent repeat catheterization revealed total thrombotic occlusion of both stents, requiring urgent repeat intervention. Conclusion: Despite patient compliance with the currently recommended anti-platelet regimen after stent therapy for coronary artery disease, acute stent thrombosis remains a rare but life-threatening risk in both the immediate and delayed post-intervention period. In addition, premature cessation of this anti-platelet therapy stands as the greatest risk factor for such thrombotic events. This case is presented to inform emergency physicians of the current post-PCI anticoagulation recommendations to help mitigate the risk of such complications. |
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Authors:
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Matthew W Lawrence; Michael J Matteucci; Luthur I Carter; Matthew S Shepherd |
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Publication Detail:
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Type: Journal Article Date: 2008-09-26 |
Journal Detail:
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Title: The Journal of emergency medicine Volume: 41 ISSN: 0736-4679 ISO Abbreviation: J Emerg Med Publication Date: 2011 Sep |
Date Detail:
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Created Date: 2011-09-13 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8412174 Medline TA: J Emerg Med Country: United States |
Other Details:
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Languages: eng Pagination: e43-8 Citation Subset: IM |
Copyright Information:
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Published by Elsevier Inc. |
Affiliation:
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Department of Emergency Medicine, Naval Medical Center San Diego, San Diego, California. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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