title: Late peripheral stent thrombosis due to stent fracture, vigorous exercise and hyporesponsiveness to clopidogrel.
abstract: Late peripheral arterial stent thrombosis usually occurs due to haemodynamically relevant in-stent restenosis. However, late stent thrombosis may be multicausal. We report here the well-documented case of a 69-year-old man with acute thrombosis of the stented superficial femoral artery after a long-distance bicycle tour. Catheter-directed thrombolysis revealed a residual stenosis located at a stent fracture site. In addition, platelet function tests revealed an inadequate platelet response to clopidogrel. In conclusion, stent fracture, strenuous exercise and hyporesponsiveness to clopidogrel may have contributed to the development of late peripheral stent thrombosis.
authors.affiliation: Division of Vascular Medicine, Department of Internal Medicine, J.W. Goethe University Hospital, Frankfurt/Main, Germany. Birgit.Linnemann@kgu.de
authors.forename: Birgit
authors.initials: B
authors.lastname: Linnemann
authors.forename: Axel
authors.initials: A
authors.lastname: Thalhammer
authors.forename: Zsuzsanna
authors.initials: Z
authors.lastname: Wolf
authors.forename: Vanessa
authors.initials: V
authors.lastname: Tirneci
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Vogl
authors.forename: And
authors.initials: A
authors.lastname: Edelgard Lindhoff-Last
mesh_terms: D000368:Aged; D017130:Angioplasty / Q000009:adverse effects* / Q000295:instrumentation*; D001157:Arterial Occlusive Diseases / Q000628:therapy*; D001642:Bicycling; D000077144:Clopidogrel; D003251:Constriction, Pathologic; D004351:Drug Resistance; D015444:Exercise; D005263:Femoral Artery / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects*; D010979:Platelet Function Tests; D011474:Prosthesis Design; D011475:Prosthesis Failure; D011859:Radiography; D012307:Risk Factors; D015607:Stents; D015912:Thrombolytic Therapy; D013927:Thrombosis / Q000097:blood / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D013988:Ticlopidine / Q000009:adverse effects / Q000031:analogs & derivatives*; D016896:Treatment Outcome
chemical_list: D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine