Bivalirudin use during PCI for stent thrombosis in a patient with subacute intracranial hemorrhage.
Caring for patients at high risk is inherent to the practice of interventional cardiology. Recognizing high-risk situations, minimizing risk and employing preventive techniques proactively to avoid complications cannot be over-emphasized within this dynamic field. This case demonstrates real-world concerns and decision-making regarding severe bleeding risk, rescue angioplasty, stent thrombosis, appropriate usage of intravascular ultrasound and differences in stent design. Three take-home messages are identified to reduce complications in similar situations.
Giugliano
Gregory R
GR
Department of Internal Medicine, Division of Cardiology, Baystate Medical Center, The Western Campus of Tufts University School of Medicine, Springfield, Massachusetts 01199, USA. gregory.giugliano@bhs.org
Sivalingam
Senthil K
SK
D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use*; D003328:Coronary Thrombosis / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology*; D003331:Coronary Vessels / Q000000981:diagnostic imaging; D006470:Hemorrhage / Q000453:epidemiology; D006629:Hirudins / Q000009:adverse effects; D006801:Humans; D020300:Intracranial Hemorrhages / Q000150:complications*; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000009:adverse effects / Q000627:therapeutic use*; D011994:Recombinant Proteins / Q000009:adverse effects / Q000627:therapeutic use; D012307:Risk Factors; D015607:Stents / Q000009:adverse effects*; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
D000925:Anticoagulants; D006629:Hirudins; D010446:Peptide Fragments; D011994:Recombinant Proteins; C074619:bivalirudin