Nightmare: Simultaneous Subacute Stent Thrombosis of Different New-Generation Drug-Eluting Stents in Multiple Coronary Arteries.

نویسندگان

  • Po-Chao Hsu
  • Chen-An Chiu
  • Ho-Ming Su
  • Tsung-Hsien Lin
  • Chih-Sheng Chu
چکیده

UNLABELLED Simultaneous stent thrombosis (ST) of first-generation drug-eluting stents (DES) has been rarely reported and could lead to high morbidity and mortality. However, to date there was no literature discussing simultaneous ST of different new-generation DESs in multiple coronary arteries. Herein, we report a 60-year-old male suffering from acute myocardial infarction complicated with cardiogenic shock. He had percutaneous coronary intervention (PCI) performed approximately 7 days prior to admission at a local teaching hospital, with different DES devices implanted over the left anterior descending and the left circumflex artery. Emergency coronary angiography revealed simultaneous subacute ST over both vessels. After PCI, there was a gradual improvement in both cardiogenic shock and acute pulmonary edema. High dose clopidogrel (150 mg) was used initially, which was later shifted to ticagrelor. Genetic testing of CYP2C19*2 G681A polymorphism revealed heterozygous genotype and platelet function testing showed substantial inhibition after a medication change. This rare case should remind physicians that new-generation DES thrombosis in multiple vessels is still a possible complication of PCI, and checking genetic and/or platelet function testing might be indicated in these high risk patients. The use of a new antiplatelet drug was also strongly suggested to avoid possible clopidogrel resistance. KEY WORDS Clopidogrel resistance; Drug-eluting stents; Genetic testing; Platelet function; Stent thrombosis.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Simultaneous subacute thrombosis of bare metal coronary stents in two different arteries early after clopidogrel cessation.

Coronary stent thrombosis is a rare event leading to ST segment elevation myocardial infarction and death. Although early thrombosis of drug-eluting and bare metal stents is relatively frequent, simultaneous thrombosis of bare metal coronary stents has rarely been reported. Here, we present a case of simultaneous subacute thrombosis of two bare metal stents in different coronary arteries ea...

متن کامل

Simultaneous Multi-Vessel Subacute Stent Thromboses in Zotarolimus-Eluting Stents

Despite its low incidence, stent thrombosis (ST) is one of the most dreaded complications of percutaneous coronary intervention. Endeavor (Medtronics Europe SA) is a new zotarolimus-eluting stent (ZES) with a favorable safety profile that was reported in early and ongoing trials. However, few lethal stent thromboses related to this new drug eluting stent (DES) have been reported. We experienced...

متن کامل

Drug-eluting versus bare-metal stents in large coronary arteries.

BACKGROUND Recent data have suggested that patients with coronary disease in large arteries are at increased risk for late cardiac events after percutaneous intervention with first-generation drug-eluting stents, as compared with bare-metal stents. We sought to confirm this observation and to assess whether this increase in risk was also seen with second-generation drug-eluting stents. METHOD...

متن کامل

A Fatal Case of Simultaneous, Very Late Thrombosis Involving Three Drug-Eluting Stents in Three Coronary Arteries

Late stent thrombosis is one of the most serious complications associated with morbidity and mortality after coronary drug-eluting stent implantation, and is mainly caused by the withdrawal of antiplatelet agents. We report our experience of late stent thrombosis simultaneously involving three different coronary arteries in a young male patient who was treated with three drug-eluting stents two...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:
  • Acta Cardiologica Sinica

دوره 31 2  شماره 

صفحات  -

تاریخ انتشار 2015