The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
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A Case of Recurrent Stent Thrombosis in a Patient with Essential Thrombocythemia

반복적인 스텐트 혈전증이 합병된 본태성 혈소판 증다증 1예

  • Lee, Mi-Jin (Division of Cardiology, Department of Internal Medicine, Chunchoen Sacred Heart Hospital, Hallym University) ;
  • Lee, Chang-Seob (Division of Cardiology, Department of Internal Medicine, Chunchoen Sacred Heart Hospital, Hallym University) ;
  • Kim, Kyung-Lee (Division of Cardiology, Department of Internal Medicine, Chunchoen Sacred Heart Hospital, Hallym University) ;
  • Kwon, Oh-Kyoung (Division of Cardiology, Department of Internal Medicine, Chunchoen Sacred Heart Hospital, Hallym University) ;
  • Choi, Hyun-Hee (Division of Cardiology, Department of Internal Medicine, Chunchoen Sacred Heart Hospital, Hallym University) ;
  • Yoon, Duck-Hyoung (Division of Cardiology, Department of Internal Medicine, Chunchoen Sacred Heart Hospital, Hallym University) ;
  • Hong, Kyung-Soon (Division of Cardiology, Department of Internal Medicine, Chunchoen Sacred Heart Hospital, Hallym University)
  • 이미진 (한림대학교의료원 춘천성심병원 심장혈관내과) ;
  • 이창섭 (한림대학교의료원 춘천성심병원 심장혈관내과) ;
  • 김경리 (한림대학교의료원 춘천성심병원 심장혈관내과) ;
  • 권오경 (한림대학교의료원 춘천성심병원 심장혈관내과) ;
  • 최현희 (한림대학교의료원 춘천성심병원 심장혈관내과) ;
  • 윤덕형 (한림대학교의료원 춘천성심병원 심장혈관내과) ;
  • 홍경순 (한림대학교의료원 춘천성심병원 심장혈관내과)
  • Published : 2012.07.01
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Abstract

Coronary artery involvement leading to acute coronary syndrome is a rare complication of essential thrombocythemia. A 43-year-old woman with essential thrombocythemia complained of severe acute chest pain. She had undergone percutaneous coronary intervention (PCI) with a drug-eluting stent (DES), due to unstable angina, 3 and 2 years earlier. Emergency coronary angiography revealed total occlusion of the DES with thrombus. Twenty minutes after successful primary PCI with a DES, an acute stent thrombosis developed. She was subsequently treated with coronary artery bypass graft surgery.

본태성 혈소판 증다증은 골수 증식성 질환으로 혈소판 기능 부전에 의한 동,정맥의 혈전증 및 출혈이 주요한 합병증이며 특히 혈전증에 의해 뇌경색, 심근경색, 협심증, 내장혈관 혈전증 등의 주요 혈관 합병증이 발생할 수 있다. 본태성 혈소판 증다증에서 관상동맥 질환은 드물게 발생하나 관상동맥 중재술 이후 스텐트 혈전증 발생의 위험인자로 작용할 가능성이 있으며 스텐트 혈전증으로 인한 급사, 심근경색 등 치명적인 합병증이 발생할 수 있어 스텐트 삽입 치료 후 주의가 필요하다. 저자들은 본태성 혈소판 증다증으로 anagrelide (1 mg/day)를 복용 중이며, 불안정성 협심증으로 3년 전, 2년 전 각각 약물 용출 스텐트를 삽입한 병력이 있는 43세 여자 환자에 very late 스텐트 혈전증으로 급성 심근경색증이 발생하여 약물 용출 스텐트로 관상동맥 중재술을 시행한 직후 심인성 쇼크 및 심정지를 동반한 acute 스텐트 혈전증이 다시 발생되어 체외 심폐순환장치로 관류를 유지하고 응급 관상동맥 우회술로 치료하였던 증례를 경험하여 문헌고찰과 함께 보고하는 바이다.

Keywords

References

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