title: [Coronary artery bypass grafting for simultaneous subacute stent thrombosis after sirolimus-eluting stent implantation].
abstract: An 82-year-old man developed simultaneous stent thrombosis 11 days after the implantation of a sirolimus-eluting stent (SES) in the proximal left anterior descending artery (LAD) and the proximal right coronary artery (RCA). The patient immediately underwent percutaneous coronary intervention; however, his condition became critical due to the development of recurrent stent thrombosis, and emergent coronary artery bypass grafting with saphenous vein grafts was performed. Postoperative angiography showed good patency of both grafts; thrombus formation in the LAD and RCA was negative. Since the patient had a history of liver dysfunction due to ticlopidine administration, the thienopyridine derivative was not administered; this was believed to be the main cause of subacute stent thrombosis. He was administered aspirin, cilostazol, and sarpogrelate instead. A good postoperative course was achieved only using aspirin. This case demonstrates that simultaneous SES thrombosis in multivessel lesions poses a life-threatening situation.
authors.affiliation: Department of Cardiovascular Surgery, Tsuyama Chuo Hospital, Tsuyama, Japan.
authors.forename: Mitsuaki
authors.initials: M
authors.lastname: Matsumoto
authors.forename: K
authors.initials: K
authors.lastname: Suehiro
authors.forename: Y
authors.initials: Y
authors.lastname: Kubo
authors.forename: G
authors.initials: G
authors.lastname: Onoue
authors.forename: I
authors.initials: I
authors.lastname: Komatsubara
authors.forename: T
authors.initials: T
authors.lastname: Seito
authors.forename: N
authors.initials: N
authors.lastname: Morimoto
authors.forename: K
authors.initials: K
authors.lastname: Shiraishi
authors.forename: S
authors.initials: S
authors.lastname: Kasai
authors.forename: S
authors.initials: S
authors.lastname: Hagioka
authors.forename: H
authors.initials: H
authors.lastname: Naito
authors.forename: M
authors.initials: M
authors.lastname: Nagae
mesh_terms: D000369:Aged, 80 and over; D000787:Angina Pectoris / Q000628:therapy; D001241:Aspirin / Q000008:administration & dosage; D001026:Coronary Artery Bypass; D023903:Coronary Restenosis / Q000209:etiology; D003328:Coronary Thrombosis / Q000209:etiology* / Q000601:surgery*; D054855:Drug-Eluting Stents / Q000009:adverse effects*; D004630:Emergencies; D006801:Humans; D008297:Male; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage; D020123:Sirolimus / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D010975:Platelet Aggregation Inhibitors; D001241:Aspirin; D020123:Sirolimus