Cihan ŞENGÜL, OLCAY ÖZVEREN, Hakan FOTBOLCU, İsmet DİNDAR

Very late bare metal stent thrombosis: what can be the role of ınstent re-stenosis and hyperhomocysteinemia?

Altmışiki yaşındaki erkek acil servise göğüs ağrısı şikayeti ile kabul edildi. İstirahat elektrokardiyografisinde inferior derivasyonlarda ST yükselmesi saptaması üzerine hastaya akut inferior miyokard infarktüsü tanısı konuldu. Hastadan edinilen tıbbi hikaye doğrultusunda 45 ay öncesinde başka bir merkezde kararlı angina pektoris kliniği ile sirkumfleks koroner arterine çıplak metal stent takıldığı öğrenildi. Acil yapılan koroner anjiografisinde sirkumfleks arterdeki önceki stentin akut oklüzyonu saptandı. Balon anjioplasti ardından yeni bir çıplak metal stent implante edilerek sirkumfleks arterde TIMI-3 akım elde edildi. Sigara kullanmadığı bilinen hastada tromboz etyolojisini saptamak amaçlı yapılan testler sonucunda vitamin B12 eksikliği ve hiperhomosisteinemi saptandı.

Çok geç dönem çıplak metal stent trombozu: stent içi restenozun ve hiperhomosisteineminin rolü ne olabilir?

A 62-years old man was admitted to emergency department suffering from chest pain. Resting ECG revealed ST elevation on inferior leads and he was diagnosed with acute inferior myocardial infarction. His past medical history revealed that a bare metal stent had been implanted in his circum- flex coronary artery upon stable angina pectoris 45 months ago. Immediately performed coronary angiography demonstrated the occlusion of the stent in the circumflex coronary artery. A new bare metal stent was implanted and TIMI 3 flow was established after initial balloon angioplasty. No other causes but vitamin B12 deficiency and hyperhomocysteinemia were found for this non-smoker patient among other laboratory tests.

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