Background and objective: Coronary angioplasty is one of the techniques introduced in 1976 by Andreas Grüntzig in Zurich. It is a revolutionary procedure that allows coronary circulation to be restored by inserting a stent. This new technique has considerably evolved over time, but sometimes has limitations, such as the development of neo-pathologies like stent thrombosis. The aim of our case report is to highlight one of the limitations of coronary angioplasty, although rare, and to encourage greater clinical and electrical monitoring after each procedure. Case report: We report the case of a patient who presented with early stent thrombosis barely an hour after placement of a pharmacoactive stent. Chest pain reported by the patient after the procedure and electrical changes prompted an urgent repeat procedure. Aetiologies of stent thrombosis are multifactorial, including patient-, procedure- and stent-dependent factors. Conclusion: Although rare, there is a risk of stent thrombosis after coronary angioplasty. Careful monitoring and rigorous follow-up of patients after coronary angioplasty are therefore required, as the prognosis for stent thrombosis is fairly poor.
References
[1]
Wennberg, D.E., Lucas, F.L., Siewers, A.E., Kellett, M.A. and Malenka, D.J. (2004) Résultats de l’angioplastie coronaire en fonction de la présence ou non sur site d’une chirurgie de pontage coronarien. JAMA, 292, 1961-1968
[2]
Cutlip, D.E., Windecker, S., Mehran, R., Boam, A., Cohen, D.J., van Es, G., et al. (2007) Clinical End Points in Coronary Stent Trials. Circulation, 115, 2344-2351. https://doi.org/10.1161/circulationaha.106.685313
[3]
Mboup, M.C., Moquet, B., Zabalawi, A. and Delaunay, R. (2013) Thrombose très tardive d’un stent nu dix ans après son implantation : A propos d’une observation. Annales de Cardiologie et d'Angéiologie, 62, 435-437. https://doi.org/10.1016/j.ancard.2012.04.005
[4]
Schömig, A., Neumann, F., Kastrati, A., Schühlen, H., Blasini, R., Hadamitzky, M., et al. (1996) A Randomized Comparison of Antiplatelet and Anticoagulant Therapy after the Placement of Coronary-Artery Stents. New England Journal of Medicine, 334, 1084-1089. https://doi.org/10.1056/nejm199604253341702
[5]
Virmani, R., Farb, A., Guagliumi, G. and Kolodgie, F.D. (2004) Drug-eluting Stents: Caution and Concerns for Long-Term Outcome. Coronary Artery Disease, 15, 313-318. https://doi.org/10.1097/00019501-200409000-00003
[6]
Taniuchi, M., Kurz, H.I. and Lasala, J.M. (2001) Randomized Comparison of Ticlopidine and Clopidogrel after Intracoronary Stent Implantation in a Broad Patient Population. Circulation, 104, 539-543. https://doi.org/10.1161/hc3001.093435
El-Mourad, M. (2014) Myocardial Ischemia in General Medicine and the Coronary Stent Revolution. Revue Medicale de Bruxelles, 35, 306-311.
[9]
Lemesle, G., Delhaye, C., Bonello, L., de Labriolle, A., Waksman, R. and Pichard, A. (2008) Stent Thrombosis in 2008: Definition, Predictors, Prognosis and Treatment. Archives of Cardiovascular Diseases, 101, 769-777. https://doi.org/10.1016/j.acvd.2008.10.006
[10]
(2023) Thromboses de stents: facteurs favorisants. https://www.realites-cardiologiques.com/wp-content/uploads/sites/2/2010/11/018.pdf
[11]
(2013) Thrombose de stent en 2013. https://www.cardiologie-pratique.com/journal/article/0010276-thrombose-de-stent-en-2013
