Recurrent coronary stent thrombosis.
A 63-year-old woman with an acute anterior myocardial infarction was treated with primary stent implantation. The absence of coronary artery stenosis and an haematocrit of 58 were indicative of a myeloproliferative disorder and the diagnosis of polycythaemia vera (Vaquez' disease) was confirmed by bone marrow aspiration. The patient had a re-infarction 8 days later. A rescue percutaneous angioplasty was performed for stent thrombosis after unsuccessful thrombolysis. A few hours after sheath removal, a femoral artery thrombosis at the puncture side needed urgent thrombectomy. Finally, a second re-infarction occurred, followed by an irreversible cardiac arrest. Stent thrombosis is a difficult-to-treat complication in patients with polycythaemia vera. If this haematologic disorder is known, primary stent implantation for acute myocardial infarction may not be the first choice in these patients.
Goethals
P
P
Department of Cardiology, Algemene Kliniek Sint Jan, Brussels. peter.goet@gmcc-stjean.org
Evrard
S
S
Dubois
C
C
D015906:Angioplasty, Balloon, Coronary; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation*; D017023:Coronary Angiography; D003328:Coronary Thrombosis / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D004562:Electrocardiography; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology / Q000601:surgery*; D011087:Polycythemia Vera / Q000150:complications / Q000175:diagnosis; D011475:Prosthesis Failure; D012008:Recurrence; D012086:Reoperation; D015607:Stents