Vol 6, No 3 (2021)
Case report
Published online: 2021-07-05

open access

Page views 5982
Article views/downloads 479
Get Citation

Connect on Social Media

Connect on Social Media

Patient after extensive crushing injury of the lower limb with subacute stent thrombosis

Michał Kasprzak1
Medical Research Journal 2021;6(3):270-273.

Abstract

Percutaneous transluminal coronary angioplasty with stent implantation is a basic life-saving treatment
of stenotic lesions causing acute coronary syndromes. Stent thrombosis is one of the most serious
complications of coronary angioplasty, strongly associated with recurrent myocardial infarction and high
mortality. Many factors were identified as increasing the incidence of stent thrombosis including bleeding
and inflammation. I am presenting a case of a 54-year-old man after extensive crushing injury of the lower
limb with simultaneous stent thrombosis in two recently implanted stents. As a preventive measure for
stent thrombosis novel potent antiplatelet agents may be a reasonable choice even for patients with high
bleeding risk.

Article available in PDF format

View PDF Download PDF file

References

  1. Heestermans AA, van Werkum JW, Zwart B, et al. Acute and subacute stent thrombosis after primary percutaneous coronary intervention for ST-segment elevation myocardial infarction: incidence, predictors and clinical outcome. J Thromb Haemost. 2010; 8(11): 2385–2393.
  2. Byrne RA, Joner M, Kastrati A. Stent thrombosis and restenosis: what have we learned and where are we going? The Andreas Grüntzig Lecture ESC 2014. Eur Heart J. 2015; 36(47): 3320–3331.
  3. Tada T, Byrne RA, Simunovic I, et al. Risk of stent thrombosis among bare-metal stents, first-generation drug-eluting stents, and second-generation drug-eluting stents: results from a registry of 18,334 patients. JACC Cardiovasc Interv. 2013; 6(12): 1267–1274.
  4. Räber L, Magro M, Stefanini GG, et al. Very late coronary stent thrombosis of a newer-generation everolimus-eluting stent compared with early-generation drug-eluting stents: a prospective cohort study. Circulation. 2012; 125(9): 1110–1121.
  5. Palmerini T, Benedetto U, Biondi-Zoccai G, et al. Long-term safety of drug-eluting and bare-metal stents: evidence from a comprehensive network meta-analysis. J Am Coll Cardiol. 2015; 65(23): 2496–2507.
  6. Neumann FJ, Sousa-Uva M, Ahlsson A, et al. ESC Scientific Document Group, ESC Scientific Document Group. Considerations for the choice between coronary artery bypass grafting and percutaneous coronary intervention as revascularization strategies in major categories of patients with stable multivessel coronary artery disease: an accompanying article of the task force of the 2018 ESC/EACTS guidelines on myocardial revascularization. Eur Heart J. 2019; 40(2): 204–212.
  7. Park DW, Yun SC, Lee JY, et al. C-reactive protein and the risk of stent thrombosis and cardiovascular events after drug-eluting stent implantation. Circulation. 2009; 120(20): 1987–1995.
  8. Hwang SJ, Park KW, Kwon DA, et al. Korea Stent Thrombosis Investigators. High plasma interleukin-6 is associated with drug-eluting stent thrombosis: possible role of inflammatory cytokines in the development of stent thrombosis from the Korea Stent Thrombosis Registry. Circ J. 2011; 75(6): 1350–1357.
  9. Katayama T, Nakashima H, Takagi C, et al. Predictors of sub-acute stent thrombosis in acute myocardial infarction patients following primary coronary stenting with bare metal stent. Circ J. 2006; 70(2): 151–155.
  10. Wiviott SD, Braunwald E, McCabe CH, et al. TRITON-TIMI 38 Investigators. Intensive oral antiplatelet therapy for reduction of ischaemic events including stent thrombosis in patients with acute coronary syndromes treated with percutaneous coronary intervention and stenting in the TRITON-TIMI 38 trial: a subanalysis of a randomised trial. Lancet. 2008; 371(9621): 1353–1363.
  11. Steg PG, Harrington RA, Emanuelsson H, et al. PLATO Study Group. Stent thrombosis with ticagrelor versus clopidogrel in patients with acute coronary syndromes: an analysis from the prospective, randomized PLATO trial. Circulation. 2013; 128(10): 1055–1065.
  12. Armstrong EJ, Sab S, Singh GD, et al. Predictors and outcomes of recurrent stent thrombosis: results from a multicenter registry. JACC Cardiovasc Interv. 2014; 7(10): 1105–1113.
  13. Shimada YJ, Bansilal S, Wiviott SD, et al. PLATO Investigators, PLATO study group, PLATO Study Group, PLATO investigators, PLATO Investigators. Ticagrelor versus clopidogrel in patients with acute coronary syndromes. N Engl J Med. 2009; 361(11): 1045–1057.
  14. Armstrong EJ, Feldman DN, Wang TY, et al. Clinical presentation, management, and outcomes of angiographically documented early, late, and very late stent thrombosis. JACC Cardiovasc Interv. 2012; 5(2): 131–140.