Korean Circ J.  2012 Jul;42(7):487-491. 10.4070/kcj.2012.42.7.487.

Acute Coronary Stent Thrombosis in Cancer Patients: A Case Series Report

• Lee JM
• Yoon CH

• KMID: 2094121
• DOI: http://doi.org/10.4070/kcj.2012.42.7.487

Abstract

There have been a growing numbers of patients diagnosed with malignancy and coronary artery disease simultaneously or serially. In the era of percutaneous coronary intervention (PCI), stent thrombosis has been a rare but challenging problem. Recently, we experienced two unique cases of acute stent thrombosis in patients with malignancy. The first case showed acute and subacute stent thrombosis after PCI. The second case revealed simultaneous thromboses in stent and non-treated native coronary artery. We believe that we need rigorous precautions in the treatment of patients with coronary artery disease and malignancy, especially with regards to deciding how and whether to revascularize, as well as which anti-platelet agents to select.

Keyword

Coronary thrombosis; Thrombosis; Neoplasms; Pancreatic neoplasms; Lung neoplasms; Coronary angiography; Stent thrombosis

MeSH Terms

Coronary Angiography
Coronary Artery Disease
Coronary Thrombosis
Coronary Vessels
Humans
Lung Neoplasms
Pancreatic Neoplasms
Percutaneous Coronary Intervention
Stents
Thrombosis

Figure

• 

  Fig. 1 A case of recurrent stent thrombosis. A: a chest CT shows atelectasis and abrupt narrowing in right upper lobar bronchus due to squamous cell carcinoma (arrow). B: AP view; LAD was nearly occluded (arrow head). Proximal LCX shows a significant stenosis (arrow). C: AP cranial view; LAD (arrow head) and LCX (arrow) were successfully revascularized. D: electrocardiogram at the event showed ST-segment elevations in V 4, V 5, and V 6. F: AP view; emergent angiography demonstrated intraluminal thrombi in the LAD (arrow head) and LCX stents (arrow). E: AP view; emergent angiography demonstrated thrombotic total occlusion of the LCX stent (arrow) and some thrombi in LAD stent (arrow head). AP: anterioposterior, LAD: left anterior descending artery, LCX: left circumflex artery.

• 

  Fig. 2 A case of simultaneous acute thrombosis in stent and native coronary artery. A: a CT scan of the abdomen reveals a pericolic abscess with pneumoretroperitoneum at the right perirenal space and a pancreatic tail mass invading into the left kidney (arrow). B: anterioposterior view; coronary angiography reveals a near total occlusion in the proximal LAD (arrow) which triggered intractable cardiogenic shock in this patient. C: right anterior oblique caudal view; the lesion was successfully revascularized (arrow). D: electrocardiogram at the event shows pulseless ventricular tachycardia. LAD: left anterior descending artery. E: emergency coronary angiography at the event identified a total occlusion of the proximal LAD stent with an extensive thrombus (arrow). F: left anterior oblique view; the patient had also developed a new thrombus in the distal right coronary artery that had not been seen during the previous angiography (arrow).

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