Korean Circ J.  2008 Feb;38(2):122-127. 10.4070/kcj.2008.38.2.122.

A Case Report of Recurrent Subacute Stent Thrombosis After Repetitive Percutaneous Coronary Interventions

• Kang MS
• Jeung KJ
• Kim JH
• Seo HS
• Bang DW
• Cho YH
• Lee NH
• Hyon MS
• Kim SK
• Kwan YJ

• KMID: 2225853
• DOI: http://doi.org/10.4070/kcj.2008.38.2.122

Abstract

Stent thrombosis (ST) is one of the major complications that occur in percutaneous coronary interventions (PCIs) with stents. Various factors have been attributed to the development of ST, and several strategies have been recommended for its management. We report the case of a patient suffering from recurrent subacute STs after recurrent PCIs. The patient was treated by coronary artery bypass graft (CABG).

Keyword

Stents; Thrombosis

MeSH Terms

Coronary Artery Bypass
Humans
Percutaneous Coronary Intervention
Stents
Stress, Psychological
Thrombosis
Transplants

Figure

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  Fig. 1 ECG showed third degree atrioventricular block (data obtained from another hospital). ECG: electrocardiography.

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  Fig. 2 Initial finding of coronary angiogram. CAG showed the culprit lesion (dark arrow) of the subtotally occluded proximal portion of the LAD with TIMI grade 3 flow (A) and 70% stenosis (dotted arrow) in the middle segment of the RCA (B). CAG: coronary angiography, LAD: left anterior descending artery, TIMI: thrombolysis in myocardial infarction, RCA: right coronary artery.

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  Fig. 3 CAG showed no residual stenosis in each lesion after 2 Cypher stents (Cordis/Johnson & Johnson, USA) were implanted in the lesions. A: post PCI angiography revealed well-deployed SES in mid portion of the LAD. B: post PCI angiography revealed well-deployed SES in mid portion of the RCA. CAG: coronary angiography, PCI: percutaneous coronary intervention.

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  Fig. 4 ECG showed ST segment elevation in leads V2-V4. ECG: electrocardiography.

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  Fig. 5 Second findings of coronary angiogram. The second CAG showed total occlusion (dark arrow) in the previous stent-implanted area of the LAD (A) and restored lesion (dotted arrow) after successful PCI with ReoPro (abciximab) infusion (B). CAG: coronary angiography, LAD: left anterior descending artery, PCI: percutaneous coronary intervention.

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  Fig. 6 The third finding of coronary angiogram. A, B: the third CAG showed total occlusion (dark arrow) of the pLAD and recanalized lesion (dotted arrow) after successful PCI. CAG: coronary angiography, pLAD: proximal left anterior descending artery, PCI: percutaneous coronary intervention.

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  Fig. 7 ECG showed ST segment elevation in leads V2-V6. ECG: electrocardiography.

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  Fig. 8 ECG showed ST segment elevation in leads II, III and aVF. ECG: electrocardiography.

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  Fig. 9 The fifth finding of coronary angiogram. A, B: the fifth CAG showed total occlusion (dark arrow) in the earlier stent-implanted lesion of the RCA and recanalized lesion (dotted arrow) after successful PCI. CAG: coronary angiography, RCA: right coronary artery, PCI: percutaneous coronary intervention.

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  Fig. 10 The sixth CAG revealed exactly the same lesion (dark arrow) in the RCA 10 h after the PCI. CAG: coronary angiography, RCA: right coronary artery, PCI: percutaneous coronary intervention.

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