Medicine · 2025
Does this acute myocardial infarction patient have 9 lives as cats?: A case report and literature review.
СтатьяКлинический случайОбзорНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
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Yang Shuai, Sun Jing, Zhai Hu, Miao Li, Dong Huishuai, Jiao Hongshuo, Wang Gang
Аннотация
RATIONALE: Very late stent thrombosis (VLST) is associated with high mortality rates. The use of endoluminal imaging to identify the causes of VLST is crucial. Here, we report a case of VLST occurring 7 times over 14 years, wherein both stent fracture and malapposition were confirmed by endoluminal imaging.
PATIENT CONCERNS: A 66-year-old male patient had experienced sudden, recurrent myocardial infarctions 7 times over a period of 14 years, receiving 5 stents and 2 drug-coated balloons. An Electrocardiogram showed stent thrombosis-segment elevation in the inferior wall leads. Emergency coronary angiography demonstrated total occlusion of the proximal right coronary artery. Anticoagulation, thrombus aspiration and intracoronary thrombolysis were performed to treat the coronary thrombosis.
DIAGNOSES: The etiology of VLST was confirmed as stent fracture and malapposition, based on endoluminal imaging.
INTERVENTIONS: Stent implantation was performed following balloon angioplasty using a non-compliant balloon.
OUTCOMES: The patient remained asymptomatic and free of adverse cardiovascular events during an 18-month follow-up.
LESSONS: "Three-step" strategy is suggested for VLST management. Therefore, endoluminal imaging is important.
PATIENT CONCERNS: A 66-year-old male patient had experienced sudden, recurrent myocardial infarctions 7 times over a period of 14 years, receiving 5 stents and 2 drug-coated balloons. An Electrocardiogram showed stent thrombosis-segment elevation in the inferior wall leads. Emergency coronary angiography demonstrated total occlusion of the proximal right coronary artery. Anticoagulation, thrombus aspiration and intracoronary thrombolysis were performed to treat the coronary thrombosis.
DIAGNOSES: The etiology of VLST was confirmed as stent fracture and malapposition, based on endoluminal imaging.
INTERVENTIONS: Stent implantation was performed following balloon angioplasty using a non-compliant balloon.
OUTCOMES: The patient remained asymptomatic and free of adverse cardiovascular events during an 18-month follow-up.
LESSONS: "Three-step" strategy is suggested for VLST management. Therefore, endoluminal imaging is important.