Very Late Mesenteric Bare Metal Stent Thrombosis in the Setting of Cessation of Antiplatelet Agents

We report a case of a 73 year-old man admitted for acute mesenteric ischaemia. Eight years before, he had a first mesenteric ischaemic event treated by left colectomy and angioplasty of both main coeliac artery (MCA) and superior mesenteric artery (SMA); the patient was discharged on lifelong clopid...

Full description

Saved in:
Bibliographic Details
Published in:Heart, lung & circulation lung & circulation, 2015-06, Vol.24 (6), p.e65-e67
Main Authors: Ait-Mokhtar, O, Bayet, G, Benamara, S, Brunet, J, Hager, F.X, Sainsous, J
Format: Article
Language:English
Subjects:
Acute mesenteric ischaemia
Aged
Angiography - methods
Angioplasty, Balloon - methods
Atherothrombosis
Cardiovascular
Endovascular therapy
Follow-Up Studies
Humans
Male
Mesenteric Ischemia - diagnostic imaging
Mesenteric Ischemia - therapy
Metals
Periphery artery disease
Platelet Aggregation Inhibitors - administration & dosage
Platelet Aggregation Inhibitors - adverse effects
Prosthesis Failure
Recurrence
Retreatment - methods
Risk Assessment
Severity of Illness Index
Stents - adverse effects
Tomography, X-Ray Computed - methods
Treatment Outcome
Very late stent thrombosis
Withholding Treatment
Citations: Items that this one cites
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:We report a case of a 73 year-old man admitted for acute mesenteric ischaemia. Eight years before, he had a first mesenteric ischaemic event treated by left colectomy and angioplasty of both main coeliac artery (MCA) and superior mesenteric artery (SMA); the patient was discharged on lifelong clopidogrel and aspirin. One month before his admission for the index event, he had a major haematuria; clopidogrel was stopped first, then aspirin because of recurrent haematuria. Five days after withdrawal of both antiplatelet drugs, the patient presented with acute mesenteric ischaemia. Urgent aortography showed in-stent occlusion of SMA and in-stent restenosis of MCA; we performed ad hoc thrombus aspiration of SMA and balloon angioplasty of MCA. The patient was discharged seven days after, without complications. This case shows that very late stent thrombosis in digestive artery can occur in the setting of antiplatelet arrest and urgent endovascular intervention constitutes a seductive alternative for surgery when performed early after symptoms onset.
ISSN:1443-9506
1444-2892
DOI:10.1016/j.hlc.2014.11.028