scholarly journals Simultaneous Multi-Vessel Very Late Stent Thrombosis in Acute ST-Segment Elevation Myocardial Infarction

2021 ◽  
Vol 2021 ◽  
pp. 1-3
Author(s):  
Yuefeng Chen ◽  
Michael Amponsah ◽  
Cyril Nathaniel
Keyword(s):  
Myocardial Infarction ◽  
Stent Thrombosis ◽  
Rare Complication ◽  
Coronary Intervention ◽  
Very Late Stent Thrombosis ◽  
Acute Setting ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Percutaneous Coronary

Simultaneous multi-vessel very later stent thrombosis (VLST) is a very rare complication of percutaneous coronary intervention (PCI). We present a case of simultaneous multi-vessel VLST as the cause of acute ST-segment elevation myocardial infarction (STEMI). PCI of the culprit vessel was performed at acute presentation. Resolution of in-stent thrombosis in non-culprit vessels was noted on coronary angiography 2 days later. Our case suggests that PCI for culprit lesion in acute setting may be a reasonable option for simultaneous multi-vessel VLST.

scholarly journals Efficacy and safety of thrombus aspiration in ST-segment elevation myocardial infarction: an updated systematic review and meta-analysis of randomised clinical trials

2018 ◽  
Vol 8 (1) ◽  
pp. 24-38 ◽  
Author(s):  
Nevio Taglieri ◽  
Maria Letizia Bacchi Reggiani ◽  
Gabriele Ghetti ◽  
Francesco Saia ◽  
Miriam Compagnone ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Stent Thrombosis ◽  
Primary Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
Thrombus Aspiration ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Percutaneous Coronary

Background: The role of thrombus aspiration plus primary percutaneous coronary intervention in ST-segment elevation myocardial infarction remains controversial. Methods: We performed a meta-analysis of 25 randomised controlled trials in which 21,740 ST-segment elevation myocardial infarction patients were randomly assigned to thrombus aspiration plus primary percutaneous coronary intervention or primary percutaneous coronary intervention. Study endpoints were: death, myocardial infarction, stent thrombosis and stroke. Results: On pooled analysis, the risk of death (4.3% vs. 4.8%, odds ratio (OR) 0.90, 95% confidence interval (CI) 0.79–1.03; P=0.123), myocardial infarction (2.4% vs. 2.5%, OR 0.95, 95% CI 0.80–1.13; P=0.57) and stent thrombosis (1.3% vs. 1.6%, OR 0.80, 95% CI 0.63–1.01; P=0.066) was similar between thrombus aspiration plus primary percutaneous coronary intervention and primary percutaneous coronary intervention. The risk of stroke was higher in the thrombus aspiration plus primary percutaneous coronary intervention than the primary percutaneous coronary intervention group (0.84% vs. 0.59%, OR 1.401, 95% CI 1.004–1.954; P=0.047). However, on sensitivity analysis after removing the TOTAL trial, thrombus aspiration plus primary percutaneous coronary intervention was not associated with an increased risk of stroke (OR 1.01, 95% CI 0.58–1.78). The weak association between thrombus aspiration and stroke was also confirmed by the fact that the lower bound of the 95% CI was slightly below unity after removing either the study by Kaltoft or the ITTI trial. There was no interaction between the main study results and follow-up, evidence of coronary thrombus, or study sample size. Conclusions: In patients with ST-segment elevation myocardial infarction, thrombus aspiration plus primary percutaneous coronary intervention does not reduce the risk of death, myocardial infarction or stent thrombosis. Thrombus aspiration plus primary percutaneous coronary intervention is associated with an increased risk of stroke; however, this latter finding appears weak.

scholarly journals Stent Thrombosis after Rescue Percutaneous Coronary Intervention in Acute ST-Segment Elevation Myocardial Infarction

2015 ◽  
Vol 9 (1) ◽  
pp. 127-132 ◽  
Author(s):  
Khalid Bin Thani ◽  
Fajer Al-Moosa ◽  
Eman Murad ◽  
Aisha Al-Moosa ◽  
Mohamed E. Alalawi ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Thrombolytic Therapy ◽  
Stent Thrombosis ◽  
Coronary Intervention ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Percutaneous Coronary

Main Problem:To determine the incidence of coronary stent thrombosis (ST) in patients with acute ST segment elevation myocardial infarction (STEMI) after rescue percutaneous coronary intervention (PCI). Methods:An observational study looking at the incidence of ST in a middle-eastern population. A total of 510 consecutive patients presented with ST-segment elevation myocardial infarction (STEMI) were enrolled and underwent thrombolytic therapy with a total follow-up period of 2 years. Study outcomes were ST, death, re-infarction or acute coronary syndrome requiring coronary angiography and PCI. Results:A total of 510 patients enrolled, all diagnosed with STEMI and underwent thrombolytic therapy. Only 100 subjects underwent rescue PCI with intra-coronary stenting, including 54 patients with drug-eluting stent (DES) and 46 patients with bare metal stent (BMS). During the study period and follow-up, the overall rate of ST was 13.7%, definite ST occurred in 6 patients (5.5%), probable ST in 8 patients (7.3%), and possible ST in one patient (0.9%), including 0.9% acute ST, 0.9% sub-acute ST, 2.8% late ST and 8.3% very late ST. Patients with ST were likely to have prior PCI (p=0.001), prior coronary artery bypass grafting (CABG) (p=0.002) and history of heart failure (p=0.04). Conclusion:ST is infrequent event with major consequences in patients presenting with STEMI in the first 2 years after stent implantation.

scholarly journals Ticagrelor Versus Clopidogrel in ST Segment Elevation Myocardial Infarction Patients Candidate for Primary Percutaneous Coronary Intervention

2021 ◽  
pp. 263246362110048
Author(s):  
Hassan Mohamed Ebeid ◽  
Hossameldin Abdelkhalek Rasmy Mohamed ◽  
Khaled Ahmed Elkhashab ◽  
Mohamed Abdulaziz Aljarallah ◽  
Mai Magedi Abdo ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Stent Thrombosis ◽  
Coronary Intervention ◽  
Platelet Inhibitors ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Percutaneous Coronary ◽  
History Of ◽  
Definite Stent Thrombosis

Objective: To evaluate the incidence rate of definite stent thrombosis and major adverse cardiovascular events (MACE) with Ticagrelor versus Clopidogrel in ST segment elevation myocardial infarction (STEMI) patients candidate for primary percutaneous coronary intervention (PCI). Methods: STEMI participants naïve to antiplatelets, with no history of coronary artery disease (CAD) and candidate for primary PCI were included, while participants with history of CAD were excluded. Two hundred consecutive participants were selected, divided into 2 groups of 100 participants each, received either Ticagrelor or Clopidogrel, and followed up at 3 and 6 months. Results: The percent of patients in the Ticagrelor group who developed definite stent thrombosis (in-hospital and total) was 0%, while the percent of patients in the Clopidogrel group who developed definite stent thrombosis (in-hospital and total) was 8% and 9%, respectively. There were statistically significant weak associations between the class of P2Y12 platelet inhibitors and definite stent thrombosis (in-hospital and total) (X2 = 8.33, P = .004, V = 0.204 and Χ2 = 9.424, P = .002, V = 0.217, respectively). The percent of patients in the Ticagrelor and Clopidogrel groups who developed in-hospital MACE was 1% and 9%, respectively. There was a statistically weak significant association between the class of P2Y12 platelet inhibitors and in-hospital MACE (X2 = 6.74, P = .009, V = 0.184). Conclusion: Ticagrelor is more efficacious than Clopidogrel in preventing definite stent thrombosis (in-hospital and total) and in-hospital MACE in STEMI patients.

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