Stoeckelhuber B M, Szeimies U, Spengel F A, Kueffer G
Department of Radiology, University of Munich, Pettenkoferstrasse 8a, D-80336 Munich, Germany.
Cardiovasc Intervent Radiol. 1996 May-Jun;19(3):190-2. doi: 10.1007/BF02577619.
A 56-year-old smoker presented with rest pain in his left leg and hyperfibrinogenemia. He was found to have a high-grade stenosing thrombus in a Palmaz stent which had been placed 4 years ago across a stenosing ulcerating plaque in the left common iliac artery. Systemic thrombolysis was successful but the patient refused long-term anticoagulation. He presented 2 months later with recurrent stent thrombosis and an embolus to the tibioperoneal trunk. Systemic lysis was successfully performed for the stent reobstruction but the distal embolic occlusion responded neither to systemic nor to local thrombolysis. This case suggests that patients with vascular stents and hyperfibrinogenemia and/or nicotine abuse should be considered candidates for long-term anticoagulation.
一名56岁的吸烟者出现左腿静息痛和高纤维蛋白原血症。他被发现一枚4年前放置在左髂总动脉狭窄溃疡性斑块处的帕尔马兹支架内有高度狭窄性血栓形成。全身溶栓成功，但患者拒绝长期抗凝治疗。2个月后，他因支架血栓复发和栓子栓塞至胫腓干再次就诊。针对支架再阻塞成功进行了全身溶栓，但远端栓塞性闭塞对全身和局部溶栓均无反应。该病例提示，血管支架置入且伴有高纤维蛋白原血症和/或尼古丁滥用的患者应被视为长期抗凝治疗的候选对象。
