PMC2672443_01
Angiographic images of stent thrombosis on RCA (A) and LAD (B).
vhrm-5-101f1.jpg
PMC2672443_01_vhrm-5-101f1.jpg
f1-vhrm-5-101
Emergency coronary angiography was performed and revealed thromboses of both stents (Figure 1).
Panel A: successful passage of the wire, while the balloon is inserted over another wire at the place where it stopped. Panel B and C: Final angiographic result on RCA (B) and LAD (C).
vhrm-5-101f2.jpg
PMC2672443_01_vhrm-5-101f2.jpg
f2-vhrm-5-101
Not until a second wire was sited in parallel (Figure 2A), while the balloon remained inserted over the first wire at the point where it stopped, could we successfully dilate the stent with noncompliant balloons (2.5 and 3.0 mm in diameter). A DES was chosen because the patient was diabetic. A good angiographic result (TIMI 3 flow) was obtained (Figure 2B). TIMI 3 flow (Figures 2B-C). The patient could be transferred to her referral hospital and the initial outcome was uneventful.
Pathways of platelet activation and mechanism of action of antiplatelet agents.. Abbreviations: ASA, acetylsalycilic acid; NSAIDs, nonsteroidal anti-inflameates inhibitors; PAF, platelet-activating factor; TXA2, thromboaxane-A2.
vhrm-5-101f3.jpg
PMC2672443_01_vhrm-5-101f3.jpg
f3-vhrm-5-101
ASA, thienopyridines and platelet glycoprotein IIb/IIIa inhibitors, are most commonly used to prevent and to treat disorders of arterial vascular thrombosis, with different mechanisms of action. ASA inhibits thromboxane-A2 (TXA2) production; thienopyridines, clopidogrel and ticlopidine, antagonize ADP-induced activation; and GPIIb/IIIa receptor antagonists (abciximab, tirofiban, and eptifibatide) prevent platelet fibrinogen binding (Figure 3).
PMC2672443_02