Аspects of late closing of the stent as complication of coronary stentigation in a clinical example
Abstract
A clinical case of a patient with late closure of a stent (thrombosis) as a complication of coronary stenting, which appeared in a patient with diabetes mellitus, CKD II , has been presented. It is expanded the idea of the features of preparation for coronary stenting, as well as management of patients with an increased risk of complications after stenting. The choice of the stent may be varied with or without a coating, but there is always a risk of complications such as thrombosis (closure of the stent) that can lead to a re-MI, so patients should remain under the supervision of a physician within a week in the resuscitation unit, after coronary stenting, This is especially true for elderly patients who have a concomitant pathology - SD, CKD, GB, as in this clinical case. It is also necessary to conduct a thorough examination of the patient, careful collection of anamnesis before conducting coronary stenting in order to timely identify the concomitant pathology and assess the possible risk of complications. It is also necessary to select the best antiplatelet therapy.
In order to prevent the complications of restenosis of the vessel and thrombosis in the future, patients who have passed stenting need to be registered with the cardiologist for timely control of relapses. We hope that the problem will help practitioners to carefully collect the history, identify, evaluate the risk of complications in patients, in order to prevent
Downloads
References
Благосклонная Я.В. Общность патогенетических механизмов ишемической болезни сердца и инсулиннезависимого сахарного диабета, профилактика, лечение / Я.В. Благосклонная, В.А. Алмазов, Е.И. Красильникова // Кардиология.– 1996. – Т. 36, № 5. – С. 35.
Бокерия Л.А. Интервенционные методы лечения ишемической болезни сердца / Л.А. Бокерия, Б.Г. Алекян, А. Коломбо [и др.]. – М.: Издательство НЦССХ им. А.Н. Бакулева РАМН, 2002. – 417 c.
Корчина Т.Я. Ишемическая болезнь сердца при сахарном диабете. Вопросы патогенеза, диагностики и хирургического лечения / Т.Я. Корчина. – Томск: STT, 2002. – 352 с.
Матчин Ю.Г. Непосредственные результаты эндоваскулярного лечения коронарных артерий у больных ишемической болезнью сердца / Ю.Г. Матчин, А.П. Савченко, А.А. Лякишев, Ю.Н. Беленков // Кардиология. – 2007. – № 2. – С. 15–21.
Петрова К.Н. Влияние сахарного диабета 2 типа на результаты эндоваскулярного лечения ИБС с помощью стентов с лекарственным покрытием (данные годичного наблюдения) / К.Н. Петрова, С.Г. Козлов, А.А. Лякишев, А.П. Савченко // Кардиология. – 2006. – № 12. – С. 22–26.
Aronson D. Potential mechanisms promoting restenosis in diabetic patients / D. Aronson, Z. Bloomgarden, E.J. Rayfield // J Am Coll Cardiol. – 1996. – No. 27. – P. 528–535.
Daemen J. Early and late coronary stent thrombosis of sirolimus-eluting and paclitaxel-eluting stents in routine clinical practice: data from a large two-institutional cohort study / J. Daemen, P. Wenaweser, K. Tsuchida [et al.] // Lancet. –2007. – No. 369. – P. 667–678.
Lüscher T.F. Drug-Eluting Stent and Coronary Thrombosis: Biological Mechanisms and Clinical Implications / T.F. Lüscher, J. Steffel, F.R. Eberli [et al.] // Circulation. – 2007. – No. 115. – P. 1051– 1058.
Kimura T. For the RESTART investigators. Comparisons of baseline demographics, clinical presentation, and long-term outcome among patients with early, late, and very late stent thrombosis of sirolimus-eluting stents: observations from the Registry of Stent Thrombosis for Review and Reevaluation (RESTART) / T. Kimura, T. Morimoto, K. Kozuma [et al.] // Circulation. – 2010. – No. 122. – P. 52–61.
