title: Very late mesenteric bare metal stent thrombosis in the setting of cessation of antiplatelet agents.
abstract: We report a case of a 73 year-old man admitted for acute mesenteric ischaemia. Eight years before, he had a first mesenteric ischaemic event treated by left colectomy and angioplasty of both main coeliac artery (MCA) and superior mesenteric artery (SMA); the patient was discharged on lifelong clopidogrel and aspirin. One month before his admission for the index event, he had a major haematuria; clopidogrel was stopped first, then aspirin because of recurrent haematuria. Five days after withdrawal of both antiplatelet drugs, the patient presented with acute mesenteric ischaemia. Urgent aortography showed in-stent occlusion of SMA and in-stent restenosis of MCA; we performed ad hoc thrombus aspiration of SMA and balloon angioplasty of MCA. The patient was discharged seven days after, without complications. This case shows that very late stent thrombosis in digestive artery can occur in the setting of antiplatelet arrest and urgent endovascular intervention constitutes a seductive alternative for surgery when performed early after symptoms onset.
authors: Clinique Rhône Durance, Service de Cardiologie, Avignon, France. Electronic address: aitmokhtar1@yahoo.fr.
authors: O
authors: O
authors: Ait-Mokhtar
authors: Clinique Rhône Durance, Service de Cardiologie, Avignon, France.
authors: G
authors: G
authors: Bayet
authors: Clinique Rhône Durance, Service de Cardiologie, Avignon, France.
authors: S
authors: S
authors: Benamara
authors: Clinique Rhône Durance, Service de Cardiologie, Avignon, France.
authors: J
authors: J
authors: Brunet
authors: Clinique Rhône Durance, Service de Cardiologie, Avignon, France.
authors: F X
authors: FX
authors: Hager
authors: Clinique Rhône Durance, Service de Cardiologie, Avignon, France.
authors: J
authors: J
authors: Sainsous
mesh_terms: D000368:Aged; D000792:Angiography / Q000379:methods; D000800:Angioplasty, Balloon / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D065666:Mesenteric Ischemia / Q000000981:diagnostic imaging / Q000628:therapy*; D008670:Metals; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D011475:Prosthesis Failure; D012008:Recurrence; D019233:Retreatment / Q000379:methods; D018570:Risk Assessment; D012720:Severity of Illness Index; D015607:Stents / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D028761:Withholding Treatment
chemical_list: D008670:Metals; D010975:Platelet Aggregation Inhibitors
keywords: Acute mesenteric ischaemia; Atherothrombosis; Endovascular therapy; Periphery artery disease; Very late stent thrombosis