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氯吡格雷停药后肠系膜动脉药物洗脱支架急性血栓形成。

Acute thrombosis of a mesenteric artery drug-eluting stent following clopidogrel cessation.

作者信息

Sutphin Daniel, Stevens Scott, Kirzeder Daniel, Gash Judson

机构信息

Endovascular Section, Department of Surgery, University of Tennessee Medical Center, Knoxville, Tennessee 37920, USA.

出版信息

Vasc Endovascular Surg. 2007;41(6):564-7. doi: 10.1177/1538574407306242.

Abstract

LEARNING OBJECTIVE

To describe thrombosis of sirolimus-coated mesenteric arterial stents following cessation of clopidogrel therapy.

BACKGROUND

Cardiac drug-eluting stent thrombosis following cessation of antiplatelet therapy with clopidogrel has been associated with increased mortality. The application of such stents in the mesenteric arterial system and the subsequent need for clopidogrel therapy has not been studied. This is the first case report of acute thrombosis of a drug-coated stent in the mesenteric circulation.

CLINICAL FINDINGS

Acute mesenteric ischemia secondary to thrombosis of a mesenteric arterial stent following clopidogrel cessation is described.

CONCLUSION

Drug-eluting stents represent an option for mesenteric revascularization in the surgically complicated abdomen. As in the setting of cardiac stenting, acute thrombosis of these devices following cessation of clopidogrel therapy is a concern. Indefinite clopidogrel therapy following deployment of drug-coated stents should be considered.

摘要

学习目标

描述停用氯吡格雷治疗后西罗莫司涂层肠系膜动脉支架的血栓形成情况。

背景

停用氯吡格雷抗血小板治疗后心脏药物洗脱支架血栓形成与死亡率增加相关。此类支架在肠系膜动脉系统中的应用以及随后对氯吡格雷治疗的需求尚未得到研究。这是肠系膜循环中药物涂层支架急性血栓形成的首例病例报告。

临床发现

描述了停用氯吡格雷后肠系膜动脉支架血栓形成继发的急性肠系膜缺血情况。

结论

药物洗脱支架是手术复杂腹部肠系膜血运重建的一种选择。与心脏支架置入情况一样,停用氯吡格雷治疗后这些装置的急性血栓形成令人担忧。应考虑在药物涂层支架置入后进行无限期氯吡格雷治疗。

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