Drug-eluting stent thrombosis after cilostazol withdrawal in a patient previously treated with triple antiplatelet therapy

Int J Cardiol. 2009 Jun 26;135(2):e55-7. doi: 10.1016/j.ijcard.2008.03.084. Epub 2008 Jun 26.

Abstract

Antiplatelet therapy has been shown to reduce cardiac events after coronary stenting. However, despite aggressive antiplatelet therapy, stent thrombosis remains a serious complication of coronary stenting with drug-eluting stent (DES). Although several predictors for DES thrombosis have been suggested by investigators, this serious condition is still not completely preventable now. In particular, patients undergoing non-cardiac surgery or invasive procedures with bleeding risk may interrupt antiplatelet therapy and occasionally experience stent thrombosis. We report a case of DES thrombosis after cilostazol withdrawal for colonoscopic polypectomy in a patient previously treated with triple antiplatelet therapy. The patient presented with acute myocardial infarction but survived after successful emergency coronary revascularization. We discuss a plausible mechanism for DES thrombosis in the described case.

Publication types

  • Case Reports
  • Letter

MeSH terms

  • Aged
  • Cilostazol
  • Coronary Thrombosis / diagnostic imaging
  • Coronary Thrombosis / etiology*
  • Coronary Thrombosis / prevention & control
  • Digestive System Surgical Procedures
  • Drug-Eluting Stents / adverse effects*
  • Humans
  • Male
  • Platelet Aggregation Inhibitors / administration & dosage
  • Platelet Aggregation Inhibitors / adverse effects*
  • Radiography
  • Substance Withdrawal Syndrome / diagnostic imaging*
  • Tetrazoles / administration & dosage
  • Tetrazoles / adverse effects*

Substances

  • Platelet Aggregation Inhibitors
  • Tetrazoles
  • Cilostazol