Coronary stent occlusion after platelet transfusion: a case series.
Early stent occlusion after myocardial infarction is associated with increased morbidity and mortality, and antiplatelet drugs are applied to prevent these complications. We report on 3 patients with gastrointestinal bleeding or who were scheduled for emergency surgery and who received donor platelet transfusion early in the course after stenting. These patients had symptomatic coronary artery stenoses and were treated with antiplatelet therapy. Stent occlusion was diagnosed 6 to 17 hours after donor platelet transfusion, suggested by electrocardiographic and, in 1 patient, angiographic findings. One patient died of intractable bleeding from the gastrointestinal tract. Our observations emphasize the risks involved in platelet transfusion, and support withholding such therapy, unless vitally indicated, in patients who have undergone recent bare-metal coronary artery stent implantation.
Cornet
Alexander D
AD
Department of Intensive Care, V.U. Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.
Klein
Lucas J
LJ
Groeneveld
A B Johan
AB
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D003328:Coronary Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D017202:Myocardial Ischemia / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy; D017713:Platelet Transfusion / Q000009:adverse effects*; D015607:Stents / Q000009:adverse effects*; D013921:Thrombocytopenia / Q000150:complications / Q000628:therapy*