The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
권호 표지
DOI QR코드

DOI QR Code

Recurrent Stent Thrombosis in Different Coronary Arteries

다른 관상동맥에서 반복적으로 발생한 스텐트 내 혈전

  • Cho, Sun Young (Department of Internal Medicine, Dankook University College of Medicine) ;
  • Shin, Kyoung Hwang (Department of Internal Medicine, Dankook University College of Medicine) ;
  • Shin, Hyun Sung (Department of Internal Medicine, Dankook University College of Medicine) ;
  • Lee, Su Jin (Department of Internal Medicine, Dankook University College of Medicine) ;
  • Lee, Ji Eun (Department of Internal Medicine, Dankook University College of Medicine) ;
  • Jung, Kyong Yeun (Department of Internal Medicine, Dankook University College of Medicine) ;
  • Kang, Tae Soo (Department of Internal Medicine, Dankook University College of Medicine)
  • 조선영 (단국대학교 의과대학 내과학교실) ;
  • 신경황 (단국대학교 의과대학 내과학교실) ;
  • 신현성 (단국대학교 의과대학 내과학교실) ;
  • 이수진 (단국대학교 의과대학 내과학교실) ;
  • 이지은 (단국대학교 의과대학 내과학교실) ;
  • 정경연 (단국대학교 의과대학 내과학교실) ;
  • 강태수 (단국대학교 의과대학 내과학교실)
  • Received : 2012.05.11
  • Accepted : 2012.07.06
  • Published : 2013.04.01
⟨ Previous Next ⟩

Abstract

Drug-eluting stents (DES) dramatically reduce the rate of restenosis and the need for repeat revascularization. Despite these promising results, stent thrombosis seems to occur more frequently with DES and often seems to be associated with premature discontinuation of antiplatelet agents. We experienced a case of recurrent stent thrombosis with separate lesions. Recurrent stent thrombosis is a very rare event, and simultaneous stent thrombosis is also rare. Here, we report a case of recurrently developing stent thrombosis involving separate lesions.

약물방출 스텐트(drug-eluting stents, DES)의 등장으로 관상동맥 중재술 후 재협착율 및 재시술 비율이 현저하게 감소하였다. 그러나 이런 결과에도 불구하고, 일반 스텐트에 비해 높은 혈전생성 경향성 때문에 약물방출 스텐트 삽입 후에 발생하는 스텐트 내 혈전 예방에 관하여 광범위하게 논의되어 왔다. 항혈소판 약물요법에도 불구하고, 반복적으로 스텐트 내 혈전이 발생하는 것은 드문 것으로 알려져 있고, 게다가 혈전이 다른 부위에서 반복적으로 발생하는 것은 더욱 드물다. 저자들은 두 배 용량의 clopidogrel을 포함한 항혈소판 삼제 요법으로 치료받던 72세 남자에게서 다른 두 스텐트 내 반복적으로 혈전이 발생했던 증례를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

Keywords

References

  1. Airoldi F, Colombo A, Morici N, et al. Incidence and predictors of drug-eluting stent thrombosis during and after discontinuation of thienopyridine treatment. Circulation 2007;116:745-754. https://doi.org/10.1161/CIRCULATIONAHA.106.686048
  2. Win HK, Caldera AE, Maresh K, et al. Clinical outcomes and stent thrombosis following off-label use of drug-eluting stents. JAMA 2007;297:2001-2009. https://doi.org/10.1001/jama.297.18.2001
  3. Park SH, Hong GR, Seo HS, Tahk SJ. Stent thrombosis after successful drug-eluting stent implantation. Korean Circ J 2005;35:163-171. https://doi.org/10.4070/kcj.2005.35.2.163
  4. Lee SW, Park SW, Hong MK, et al. Triple versus dual antiplatelet therapy after coronary stenting: impact on stent thrombosis. J Am Coll Cardiol 2005;46:1833-1837. https://doi.org/10.1016/j.jacc.2005.07.048
  5. Kim JS, Lee KS, Kim YI, Tamai Y, Nakahata R, Takami H. A randomized crossover comparative study of aspirin, cilostazol and clopidogrel in normal controls: analysis with quantitative bleeding time and platelet aggregation test. J Clin Neurosci 2004;11:600-602. https://doi.org/10.1016/j.jocn.2003.10.022
  6. Matetzky S, Shenkman B, Guetta V, et al. Clopidogrel resistance is associated with increased risk of recurrent atherothrombotic events in patients with acute myocardial infarction. Circulation 2004;109:3171-3175. https://doi.org/10.1161/01.CIR.0000130846.46168.03
  7. van Werkum JW, Heestermans AA, de Korte FI, et al. Long-term clinical outcome after a first angiographically confirmed coronary stent thrombosis: an analysis of 431 cases. Circulation 2009;119:828-834. https://doi.org/10.1161/CIRCULATIONAHA.108.799403
  8. Moon JY, Jeong MH, Kim IS, et al. Long-term clinical outcome and prognosis after treatment of the first generation drug-eluting stent thrombosis. Int J Cardiol 2010;145:564-566. https://doi.org/10.1016/j.ijcard.2010.05.034