Korean Circ J.  2012 Jan;42(1):54-57. 10.4070/kcj.2012.42.1.54.

A Case of Late Stent Thrombosis Following Platelet Transfusion in a Patient With Aplastic Anemia

• Shin HS
• Kang TS

• KMID: 2297909
• DOI: http://doi.org/10.4070/kcj.2012.42.1.54

Abstract

Aplastic anemia is a condition in which the bone marrow fails to produce adequate numbers of peripheral blood elements. The incidences of atherosclerosis and myocardial infarction in patients with congenital coagulation disorders and chronic thrombocytopenia are very low. In this paper, a case of late stent thrombosis within a drug-eluting stent occurring after platelet transfusion in a patient with aplastic anemia is presented. The authors' observations emphasize the risks of platelet transfusion and the authors' support withholding such a treatment unless vitally indicated, in patients with coronary artery stent implantation and even in those on dual antiplatelet therapy.

Keyword

Stent; Thrombosis; Platelet transfusion; Aplastic, anemia

MeSH Terms

Anemia, Aplastic
Atherosclerosis
Blood Platelets
Bone Marrow
Coronary Vessels
Drug-Eluting Stents
Humans
Incidence
Myocardial Infarction
Platelet Transfusion
Stents
Thrombocytopenia
Thrombosis

Figure

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  Fig. 1 Initial electrocardiogram showed hyperacute tall T wave in the precordial leads.

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  Fig. 2 One year before this event, coronary angiography revealed a diffuse, eccentric luminal narrowing up to 90% (A) and percutaneous coronary intervention with Cypher Select 3.5×28 (Johnson & Johnson-Cordis, Miami, FL, USA) was performed due to acute coronary syndrome (arrows) (B).

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  Fig. 3 Coronary angiography of the left coronary artery. Total occlusion of the mid left anterior descending artery in the portion of the previously inserted stent (A) was noted (arrows). After balloon angioplasty with 3.0×15 mm non-complaint coronary balloon, thrombolysis in myocardial infarction 3 distal flow was obtained (B).

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