Chonnam Med J.  2014 Apr;50(1):23-26. 10.4068/cmj.2014.50.1.23.

Terrible Stent Thrombosis Induced by a Treadmill Test Performed Three Days after Percutaneous Coronary Intervention

• Kim HS
• Kim SY
• Lee UJ
• Kim W

• KMID: 1889759
• DOI: http://doi.org/10.4068/cmj.2014.50.1.23

Abstract

Generally, early exercise after coronary stenting is considered safe, but isolated cases of acute stent thrombosis have been associated with the performance of a treadmill exercise test after percutaneous coronary intervention (PCI). The treadmill exercise test is often used to noninvasively assess the functional result of PCI. In this report, we describe a case of terrible stent thrombosis related to an exercise test performed 3 days after stenting, and the patient died as the result of an intractable thrombus.

Keyword

Exercise; Stents; Thrombosis; Percutaneous coronary intervention

MeSH Terms

Exercise Test*
Humans
Percutaneous Coronary Intervention*
Stents*
Thrombosis*

Figure

• 

  FIG. 1 Result of coronary angiography (CAG). (A) CAG showed total occlusion of the right coronary artery (RCA) with good collateral flow from the left anterior descending artery (LAD). (B) Significant stenosis of the left circumflex artery (LCX) was seen. (C) A 3.0×22 mm Endeavor Resolute stent was successfully placed in the LCX.

• 

  FIG. 2 (A) During the treadmill test, the patient complained of chest pain at stage II and the electrocardiogram accordingly showed diffuse horizontal ST segment depression. (B) Emergent coronary angiography (CAG) showed total occlusion of the left circumflex artery (LCX) stent by thrombosis and thrombus invasion up to the left anterior descending artery (LAD) ostium. (C) We tried a crossover stent from the left main to the proximal LAD and succeeded in completely restoring LAD flow. (D) Severe diffuse stent thrombosis relapsed in the LAD, LCX, and left main after 5 minutes. We repeatedly tried ballooning but intractable thrombi were found everywhere.

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