The Use of Cangrelor as Bridge Antiplatelet Therapy in a Patient with Recent Percutaneous Coronary Intervention for Acute Coronary Syndrome, Who Developed Esophageal Perforation After Transesophageal Echocardiography

Turk Kardiyol Dern Ars. 2024 Jul;52(5):352-356. doi: 10.5543/tkda.2023.50000.


Dual antiplatelet therapy (DAPT) is a vital part of the pharmacological management in patients with coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI). While early discontinuation of DAPT increases ischemic risk, some patients on DAPT may require urgent surgery, necessitating its interruption. Cangrelor, an intravenous P2Y12 antagonist, provides strong platelet inhibition within minutes and platelet activity normalizes within one hour after the cessation of the drug. Bridging antiplatelet therapy with cangrelor has been increasingly studied as an alternative option to ensure the continuation of platelet inhibition in CAD patients who require discontinuation of DAPT. The present patient, with a recent history of PCI for acute coronary syndrome, experienced a significant esophageal perforation following transesophageal echocardiography (TEE). This severe complication was effectively managed endoscopically, and as part of the recent PCI treatment, prolonged cangrelor infusion was successfully utilized with no thrombotic or bleeding events throughout the management of the complication.

Publication types

  • Case Reports

MeSH terms

  • Acute Coronary Syndrome* / drug therapy
  • Acute Coronary Syndrome* / therapy
  • Adenosine Monophosphate* / administration & dosage
  • Adenosine Monophosphate* / adverse effects
  • Adenosine Monophosphate* / analogs & derivatives
  • Adenosine Monophosphate* / therapeutic use
  • Aged
  • Echocardiography, Transesophageal*
  • Esophageal Perforation*
  • Humans
  • Male
  • Middle Aged
  • Percutaneous Coronary Intervention*
  • Platelet Aggregation Inhibitors* / administration & dosage
  • Platelet Aggregation Inhibitors* / adverse effects
  • Platelet Aggregation Inhibitors* / therapeutic use


  • cangrelor
  • Adenosine Monophosphate
  • Platelet Aggregation Inhibitors