Bridging with GP IIb/IIIa inhibitors after abdominal surgery in a patient presenting with late stent thrombosis of a drug-eluting stent and who cannot receive oral antiplatelet treatment

J Invasive Cardiol. 2009 Apr;21(4):E73-6.

Abstract

Drug-eluting stents were designed to reduce neointimal hyperplasia and thus diminish the likelihood of coronary restenosis. They may, however, carry long-term risks such as delayed stent endothelization and arterial healing. Here we report a case of late stent thrombosis in a drug-eluting stent in the perioperative period after abdominal surgery in a patient who could not absorb oral antiplatelet agents and who was treated with a glycoprotein IIb/IIIa antagonist. We will present issues related to discontinuation of antiplatelet therapy before non-cardiac surgery, coronary intervention in the perioperative period and the strategy for managing patients with stent thrombosis who cannot receive oral antiplatelet treatment.

Publication types

  • Case Reports

MeSH terms

  • Administration, Oral
  • Aged
  • Aspirin / therapeutic use
  • Clopidogrel
  • Coronary Restenosis / prevention & control*
  • Coronary Thrombosis / drug therapy*
  • Drug-Eluting Stents*
  • Humans
  • Male
  • Perioperative Care*
  • Platelet Aggregation Inhibitors / therapeutic use
  • Platelet Glycoprotein GPIIb-IIIa Complex / antagonists & inhibitors*
  • Platelet Glycoprotein GPIIb-IIIa Complex / drug effects
  • Platelet Membrane Glycoprotein IIb*
  • Ticlopidine / analogs & derivatives
  • Ticlopidine / therapeutic use
  • Time Factors

Substances

  • Platelet Aggregation Inhibitors
  • Platelet Glycoprotein GPIIb-IIIa Complex
  • Platelet Membrane Glycoprotein IIb
  • Clopidogrel
  • Ticlopidine
  • Aspirin