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Successful Use of Glycoprotein IIb/IIIa Inhibitor, Heparin, and IABP During PCI in a Post-Neurosurgical Patient with STEMI and Cardiogenic Shock Due to Very Late Bare-Metal Stent Thrombosis.
MedLine Citation:
PMID:  22294539     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Stent thrombosis is not unusual in a post-operative setting. Use of heparin, aspirin, clopidogrel, and glycoprotein (GP) IIb/IIIa inhibitors in this setting needs to be balanced because of the increased risk of perioperative bleeding. This is of special concern in neurosurgery, where postoperative mass effect from bleeding in a closed space is a serious risk. We describe a unique case of inferior and anterior ST-elevation myocardial infarction in cardiogenic shock during spinal surgery with acute, very late bare-metal stent (BMS) thrombosis in the left anterior descending coronary artery and simultaneous acute thrombotic occlusion of the right coronary artery, treated by primary percutaneous intervention, intra-aortic balloon pump (IABP) support and use of GP IIb/IIIa inhibitor in addition to clopidogrel, aspirin, and heparin with good surgical and cardiac outcome. This case report describes first time use of GP IIb/IIIa inhibitor and IABP with heparin, in a patient just after spinal surgery.
Authors:
Nuri I Akkus; Saurabh Rajpal; Sujata Agnani
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of invasive cardiology     Volume:  24     ISSN:  1557-2501     ISO Abbreviation:  J Invasive Cardiol     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-02-01     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8917477     Medline TA:  J Invasive Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  76-8     Citation Subset:  IM    
Affiliation:
Department of Medicine, Louisiana State University Health Sciences Center, Shreveport, 1501 Kings Hwy, Shreveport LA, 71103 USA. rajpalsrbh@gmail.com.
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