title: Acute Carotid Artery Stent Thrombosis Due to Dual Antiplatelet Resistance.
abstract: Carotid artery stenting (CAS) is a revascularization modality that is an alternative to carotid endarterectomy. The efficacy of CAS in primary and secondary prevention from ischemic stroke has been demonstrated in various trials. Acute thrombosis of CAS is a rare complication that can lead to dramatic and catastrophic consequences. We discuss a case of acute CAS thrombosis in a patient who had previously undergone successful CAS. CAS was performed in a 73-year-old man who had had dysarthria lasting 2 weeks with 95% stenosis in his left internal carotid artery. An acute cerebrovascular event resulting in right-sided hemiplegia developed 24 h after the procedure. Computed tomographic carotid angiography revealed complete occlusion of the stent with thrombus. The cause of stent thrombosis was thought to be antiaggregant resistance to both acetylsalicylic acid and clopidogrel. The most important cause of acute CAS thrombosis is inadequate or ineffective antiaggregant therapy. Evaluating patients who are candidates for CAS for acetylsalicylic acid and clopidogrel resistance may preclude this complication.
authors.affiliation: Clinic of Cardiology, Antalya Education and Research Hospital, Yenigün Mahallesi 1067 Sokak no: 6B/13, Antalya, Turkey, drerkankoklu@gmail.com.
authors.forename: Erkan
authors.initials: E
authors.lastname: Köklü
authors.forename: Şakir
authors.initials: Ş
authors.lastname: Arslan
authors.forename: İsa Öner
authors.initials: İÖ
authors.lastname: Yüksel
authors.forename: Nermin
authors.initials: N
authors.lastname: Bayar
authors.forename: Pınar
authors.initials: P
authors.lastname: Koç
mesh_terms: D000208:Acute Disease; D000368:Aged; D001241:Aspirin / Q000008:administration & dosage; D002341:Carotid Artery Thrombosis / Q000150:complications* / Q000000981:diagnostic imaging; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging; D000077144:Clopidogrel; D004351:Drug Resistance; D004359:Drug Therapy, Combination; D006429:Hemiplegia / Q000209:etiology*; D006801:Humans; D008297:Male; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage*; D015607:Stents; D020521:Stroke / Q000209:etiology*; D013988:Ticlopidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D014057:Tomography, X-Ray Computed
chemical_list: D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin