Percutaneous coronary intervention in a patient with immune thrombocytopenia purpura.
The appropriate regimen of platelet inhibitors that should be used in patients with immune thrombocytopenia purpura (ITP; formerly called idiopathic thrombocytopenic purpura) who are undergoing percutaneous coronary intervention is unclear. We report the case of a patient with ITP who underwent two separate coronary interventions. The first involved the use of aspirin and a cutting balloon to treat obstructive disease of the left circumflex. When the patient presented with restenosis, he received eptifibatide, clopidogrel, and an intracoronary stent. He is currently 16 months removed from his second procedure and remains physically active without any anginal symptoms. Percutaneous revascularization in patients with ITP remains a challenge and this therapeutic approach, while ultimately successful in the patient, requires further validation.
C.V. Richardson Cardiac Catheterization Laboratory, Division of Cardiology, Department of Medicine, University of North Carolina, Chapel Hill, North Carolina 27599, USA. rstouff@med.unc.edu
George A
GA
Stouffer
Jana
J
Hirmerova
Stephan
S
Moll
Bryon
B
Rubery
Mark
M
Napoli
E Magnus
EM
Ohman
Ross
R
Simpson
D000368:Aged; D000800:Angioplasty, Balloon; D001241:Aspirin / Q000627:therapeutic use; D000077144:Clopidogrel; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000150:complications / Q000628:therapy*; D000077542:Eptifibatide; D006801:Humans; D008297:Male; D010455:Peptides / Q000627:therapeutic use; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000150:complications*; D015607:Stents; D013988:Ticlopidine / Q000031:analogs & derivatives* / Q000627:therapeutic use
D010455:Peptides; D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D000077542:Eptifibatide; D013988:Ticlopidine; D001241:Aspirin