ABSTRACT
Drug-eluting stents have revolutionized the management of patients with coronary artery disease by decreasing the incidence of restenosis and the need for repeat revascularization. Recent data indicate that they may, however, be associated with a small but significant increase in the risk of late stent thrombosis compared with bare-metal stents. In this review, we discuss the incidence, pathogenesis, and predictors of stent thrombosis, the most important being premature cessation of dual antiplatelet therapy. Drug-eluting stent implantation needs to be carefully considered in every patient, and the risk of stent thrombosis and bleeding needs to be weighed against the risk of restenosis. Current guidelines recommend that dual antiplatelet therapy should be continued for at least 1 year following drug-eluting stent implantation, although the optimal duration of therapy is yet unknown.
Subject(s)
Angioplasty, Balloon, Coronary , Coronary Disease/therapy , Coronary Thrombosis/epidemiology , Drug-Eluting Stents , Humans , Incidence , Platelet Aggregation Inhibitors/therapeutic use , Practice Guidelines as Topic , Time FactorsABSTRACT
A 63-year-old woman presented with a midline neck swelling which clinically appeared as goitre with bilateral cervical lymphadenopathy. Pre-operative investigations were suggestive of malignancy with lymph node metastasis for which a subtotal thyroidectomy with lymph node excision was done. But the histopathological examination of the operative specimen was reported as sinus histiocytosis of the thyroid and the cervical lymph nodes.
Subject(s)
Edema/etiology , Female , Histiocytosis, Sinus/diagnosis , Humans , Middle Aged , NeckABSTRACT
A 2-year-old male child, who was operated on 18 months earlier for tuberculous meningitis with hydrocephalus by placement of a ventriculo-peritoneal shunt, presented with the lower end of the shunt tube coming out through the anus. Colonoscopy showed the shunt tube coming out through the colon 22 cm from the anal opening. The cranial end, along with a malfunctioning valve, were disconnected surgically, and the shunt was removed endoscopically using a pediatric flexible colonoscope.