Fadah Kahtan, Patel Divyank, Mishra Kunal, Makhija Rakhee, Siddiqui Tariq
Internal Medicine, Texas Tech University Health Sciences Center El Paso Paul L. Foster School of Medicine, El Paso, USA.
Cardiovascular Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, USA.
Cureus. 2021 Sep 29;13(9):e18370. doi: 10.7759/cureus.18370. eCollection 2021 Sep.
Stent thrombosis is a devastating complication of percutaneous coronary intervention (PCI) associated with significant morbidity and mortality. Progressive technical advancements from balloon angioplasty to bare-metal stent and drug-eluting stent placement have reduced the incidence of stent thrombosis. Definitive management and preventive methods are still negligible. Here, we describe two cases of definite subacute stent thrombosis of the right coronary complicated by pericarditis and very late left anterior descending stent thrombosis after the intervention in the right coronary artery. In both cases, antiplatelet treatment with clopidogrel showed excellent compliance. Therefore, after successful PCI, we switched both cases from clopidogrel to potentially more potent antiplatelet treatment, such as ticagrelor, to reduce the occurrence of stent thrombosis in the future.
支架血栓形成是经皮冠状动脉介入治疗（PCI）的一种灾难性并发症，与显著的发病率和死亡率相关。从球囊血管成形术到裸金属支架和药物洗脱支架置入的技术不断进步，降低了支架血栓形成的发生率。但确切的治疗和预防方法仍然不足。在此，我们描述了两例右冠状动脉明确的亚急性支架血栓形成并伴有心包炎，以及右冠状动脉介入治疗后非常晚期的左前降支支架血栓形成的病例。在这两例病例中，使用氯吡格雷的抗血小板治疗均显示出良好的依从性。因此，在PCI成功后，我们将这两例病例从氯吡格雷转换为可能更有效的抗血小板治疗，如替格瑞洛，以降低未来支架血栓形成的发生率。
