The use of bivalirudin to prevent subacute thrombosis during drug-eluting stent implantation.
Subacute thrombosis is an infrequent but potentially life-threatening complication of percutaneous coronary intervention (PCI) that has received much attention in association with drug-eluting stent (DES) deployment. We performed a retrospective case record review of 186 patients receiving PCI with DES placement at our facility. Patients received either bivalirudin (n=115) or heparin (n=71) as the foundation anticoagulant, with additional antiplatelet therapy as warranted. Two subacute thrombosis complications occurred and are described in detail. There were no deaths, major bleeding episodes or other significant complications. We report our findings and conclude that the addition of a glycoprotein IIb/IIIa inhibitor does not eliminate the risk of subacute thrombosis and that bivalirudin appears to provide effective anticoagulation for patients undergoing PCI with placement of a DES.
Medina
Roberto P
RP
University Community Hospital, Tampa, Florida, USA. rmedina@tampabay.rr.com
Foto
Denise
D
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects; D000925:Anticoagulants / Q000008:administration & dosage* / Q000627:therapeutic use; D019917:Blood Vessel Prosthesis Implantation; D016503:Drug Delivery Systems; D004359:Drug Therapy, Combination; D005260:Female; D006493:Heparin / Q000008:administration & dosage; D006629:Hirudins / Q000008:administration & dosage* / Q000031:analogs & derivatives*; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000008:administration & dosage* / Q000627:therapeutic use; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000037:antagonists & inhibitors; D011183:Postoperative Complications / Q000517:prevention & control*; D011994:Recombinant Proteins / Q000008:administration & dosage* / Q000627:therapeutic use; D012189:Retrospective Studies; D015607:Stents / Q000009:adverse effects; D013927:Thrombosis / Q000209:etiology / Q000517:prevention & control*
D000925:Anticoagulants; D006629:Hirudins; D010446:Peptide Fragments; D019039:Platelet Glycoprotein GPIIb-IIIa Complex; D011994:Recombinant Proteins; D006493:Heparin; C074619:bivalirudin