Pfoch L, Mahler V, Sticherling M
Department of Dermatology, University Hospital of Erlangen, Erlangen, Germany.
Dermatology. 2009;218(1):52-5. doi: 10.1159/000171817. Epub 2008 Nov 6.
Drug-eluting stents become increasingly popular for the treatment of coronary artery disease. Consequently, side effects including hypersensitivity reactions have to be anticipated.
Here we report on a patient with an anaphylactic reaction 2 weeks after implantation of a polymer-based paclitaxel-eluting stent (Taxus, Boston Scientific). The patient presented with disseminated wheals, pruritus, bronchial asthma and acute synovitis. The reaction was successfully treated with initial intravenous injection followed by oral antihistamine treatment for 1 month until all stent-bound paclitaxel was assumed to be eluted. Thereafter no further anaphylactic reaction occurred.
This sequence of events points towards a causal relation of the stent implantation and hypersensitivity reaction with a central role of paclitaxel. The increasing use of this type of stent should therefore be carefully monitored for such adverse reactions.
药物洗脱支架在冠状动脉疾病治疗中越来越受欢迎。因此，必须预见到包括过敏反应在内的副作用。
在此，我们报告一例患者，在植入基于聚合物的紫杉醇洗脱支架（Taxus，波士顿科学公司）2周后发生过敏反应。患者出现弥漫性风团、瘙痒、支气管哮喘和急性滑膜炎。通过初始静脉注射，随后口服抗组胺药治疗1个月，直至所有与支架结合的紫杉醇被认为已洗脱，该反应得到成功治疗。此后未再发生过敏反应。
这一系列事件表明支架植入与过敏反应之间存在因果关系，紫杉醇起核心作用。因此，对于此类不良反应，应密切监测这类支架使用的增加情况。
