A Therapeutic Dilemma - Coronary Artery Stenting in the Setting of Thrombocytopaenia.

Coronary artery interventions in the setting of Immune Thrombocytopaenic Purpura (ITP) carry the twin risks of bleeding and thrombosis related to the mandatory dual anti-platelet therapy. This condition therefore may require a splenectomy prior to the coronary intervention. Surgical splenectomy in the presence of high-grade coronary stenosis carries greater morbidity and mortality. We report here a unique solution to this therapeutic dilemma, which was splenic artery embolisation followed by percutaneous coronary intervention (PCI).