ABSTRACT
Stent thrombosis (ST) is an uncommon but potentially lethal complication of coronary endoprothesis. Clinical trials have not shown differences in the incidence of early and late thrombosis among bare-metal stents and drug-eluting stents. Very late stent thrombosis occurs more than a year after stent implantation and is more specific of drug-eluting stents. Factors related to the patient, the stent, the coronary lesion and the technique are involved in the pathogenesis of ST. The main risk factor ST is the premature discontinuation of antiplatelet therapy. Currently, patients must receive aspirin and a thienopyridine for at least one month after the implantation of a bare-metal stent and 12 months after the implantation of a drug-eluting stent, then maintaining one antiplatelet agent indefinitely.
Subject(s)
Stents/adverse effects , Thrombosis/etiology , Humans , Thrombosis/therapyABSTRACT
La trombosis del stent (TS) es una complicación infrecuente pero potencialmente letal de las endoprótesis coronarias. Los ensayos clínicos no han demostrado diferencias en la incidencia de trombosis temprana y tardía entre stents convencionales (SC) y stents liberadores de fármacos antiproliferativos (SLF). La trombosis muy tardía ocurre pasado un año de la implantación del stent y es más específica de los SLF. En la etiopatogenia de la trombosis del stent intervienen factores relacionados con el paciente, el stent, la lesión y la técnica de implante. El principal factor de riesgo para la TS es la suspensión prematura de los fármacos antiplaquetarios. Actualmente los pacientes deben recibir ácido acetilsalicílico y una tienopiridina por lo menos durante un mes tras el implante de un SC y durante 12 meses tras el implante de un SLF, manteniendo posteriormente un antiplaquetario de forma indefinida (AU)
Stent thrombosis (ST) is an uncommon but potentially lethal complication of coronary endoprothesis. Clinical trials have not shown differences in the incidence of early and late thrombosis among bare-metal stents and drug-eluting stents. Very late stent thrombosis occurs more than a year after stent implantation and is more specific of drug-eluting stents. Factors related to the patient, the stent, the coronary lesion and the technique are involved in the pathogenesis of ST. The main risk factor ST is the premature discontinuation of antiplatelet therapy. Currently, patients must receive aspirin and a thienopyridine for at least one month after the implantation of a bare-metal stent and 12 months after the implantation of a drug-eluting stent, then maintaining one antiplatelet agent indefinitely (AU)
Subject(s)
Humans , Graft Occlusion, Vascular/complications , Blood Vessel Prosthesis/adverse effects , Infusion Pumps, Implantable/adverse effects , Aspirin/therapeutic use , Postoperative Care/methods , Postoperative Complications/prevention & controlABSTRACT
Percutaneous transluminal coronary angioplasty is a useful therapeutic tool in the treatment of ischemic heart disease. Nowadays this procedure presents acute complications of different severity in 10% of the cases. The rupture of the guide wire is a very uncommon complication that may produce important consequences as occlusion of the artery of systemic embolism. The management of this event may be interventional or conservative, depending on the clinical situation of the patient and the position of the guide wire inside the vessel. We report the 2 cases of rupture of the guide wire observed in our center in 1,000 consecutive procedures; in one case it was decided to leave the fragment in the distal portion of the artery, and in the other case the fragment was extracted surgically. We review the literature about this rare complication.
Subject(s)
Angioplasty, Balloon, Coronary/adverse effects , Coronary Vessels , Foreign Bodies/etiology , Adult , Angina Pectoris/complications , Angina Pectoris/therapy , Angioplasty, Balloon, Coronary/instrumentation , Coronary Angiography , Coronary Disease/complications , Coronary Disease/therapy , Equipment Failure , Foreign Bodies/diagnostic imaging , Foreign Bodies/surgery , Humans , Male , Middle AgedABSTRACT
We present the case of a patient with a dilated cardiomyopathy in which an anomaly in the origin of the left coronary artery, that arose from the right sinus of Valsalva through an own ostium and followed a retro aortic course, was recognized as an angiographic finding. The possible pathways the anomalous artery may follow, and their different clinical significances are reviewed. The angiographic sign of the aortic root, described for the identification of the anomalous origin of circumflex artery, is reviewed and its utility in the case of anomalous left coronary artery is demonstrated. In our case, Thallium-201 didn't show myocardial ischemia with the exercise and that justified, beside the doubtful efficacy of surgery as prophylaxis of sudden death when the anomalous course is retro-aortic, to maintain a conservative attitude.
Subject(s)
Cardiomyopathy, Dilated/complications , Coronary Vessel Anomalies/complications , Sinus of Valsalva/abnormalities , Adult , Coronary Vessel Anomalies/diagnostic imaging , Humans , Male , RadiographyABSTRACT
We present a case of aneurysm of interatrial septum associated with rheumatic mitral stenosis, which supports the theory that claims that the pressure gradient between the atriums plays an important part in its aetiology. The angiographic image of a filling defect in the right atrium may cause an erroneous diagnosis of atrial tumour. The levophase of right angiography and cross-sectional echocardiography confirmed the diagnosis of aneurysm of interatrial septum.
