Thrombocytosis as a potential cause of a very late stent thrombosis in the left main coronary artery.

Abstract

A 36 year-old man, who had undergone a paclitaxel-eluting stent deployment into the left main (LM) coronary artery three years before, was admitted after successful resuscitation following out-of-hospital cardiac arrest due to an acute ST-segment elevation myocardial infarction. Six weeks before the admission, he had discontinued clopidogrel. Coronary angiography showed a total occlusion of the LM artery. A complex percutaneous coronary intervention including thrombectomy and a second everolimus-eluting stent deployment in the LM artery and the left descending coronary artery was performed; this resulted in the restoration of TIMI 2/3 flow. A detailed investigation revealed an essential thrombocytosis necessitating treatment with hydroxyurea and indefinite dual antiplatelet therapy.

• Authors: Marek Prech, Magdalena Janus, Konrad Lukawski, Maciej Lesiak
• Journal: Kardiologia polska (Kardiol Pol) Vol. 71 Issue 3 Pg. 308-9 ( 2013) ISSN: 1897-4279 [Electronic] Poland
• PMID: 23575792 (Publication Type: Case Reports, Journal Article)

Chemical References

• Clopidogrel
• Ticlopidine
• Paclitaxel

Topics

• Adult
• Clopidogrel
• Coronary Angiography
• Coronary Stenosis (diagnostic imaging, etiology)
• Coronary Thrombosis (diagnostic imaging, etiology)
• Drug-Eluting Stents (adverse effects)
• Humans
• Male
• Myocardial Infarction (diagnostic imaging, etiology, therapy)
• Out-of-Hospital Cardiac Arrest (etiology, therapy)
• Paclitaxel (administration & dosage)
• Thrombocytosis (drug therapy, etiology)
• Ticlopidine (administration & dosage, analogs & derivatives)
• Withholding Treatment