Acute thrombosis of a mesenteric artery drug-eluting stent following clopidogrel cessation.
OBJECTIVE
To describe thrombosis of sirolimus-coated mesenteric arterial stents following cessation of clopidogrel therapy.


BACKGROUND
Cardiac drug-eluting stent thrombosis following cessation of antiplatelet therapy with clopidogrel has been associated with increased mortality. The application of such stents in the mesenteric arterial system and the subsequent need for clopidogrel therapy has not been studied. This is the first case report of acute thrombosis of a drug-coated stent in the mesenteric circulation.


RESULTS
Acute mesenteric ischemia secondary to thrombosis of a mesenteric arterial stent following clopidogrel cessation is described.


CONCLUSIONS
Drug-eluting stents represent an option for mesenteric revascularization in the surgically complicated abdomen. As in the setting of cardiac stenting, acute thrombosis of these devices following cessation of clopidogrel therapy is a concern. Indefinite clopidogrel therapy following deployment of drug-coated stents should be considered.
Sutphin
Daniel
D
Endovascular Section, Department of Surgery, University of Tennessee Medical Center, Knoxville, Tennessee 37920, USA. dsutphin@mc.utmck.edu
Stevens
Scott
S
Kirzeder
Daniel
D
Gash
Judson
J
D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use; D002317:Cardiovascular Agents / Q000008:administration & dosage*; D000077144:Clopidogrel; D054855:Drug-Eluting Stents / Q000009:adverse effects*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D017538:Mesenteric Artery, Superior; D008641:Mesenteric Vascular Occlusion / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology / Q000601:surgery / Q000628:therapy*; D010349:Patient Compliance; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D011857:Radiographic Image Interpretation, Computer-Assisted; D055502:Secondary Prevention; D020123:Sirolimus / Q000008:administration & dosage*; D017131:Thrombectomy; D015912:Thrombolytic Therapy; D013927:Thrombosis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology / Q000601:surgery / Q000628:therapy*; D013988:Ticlopidine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014859:Warfarin / Q000627:therapeutic use
D000925:Anticoagulants; D002317:Cardiovascular Agents; D010975:Platelet Aggregation Inhibitors; D014859:Warfarin; D000077144:Clopidogrel; D013988:Ticlopidine; D020123:Sirolimus