Treatment of the left and the right coronary arteries’ ostial lesions by stenting in a patient with ımmune thrombocytopenic purpura

Immune thrombocytopenic purpura is an autoimmune disease which is characterized with a decrease in number of platelets in blood. Gathering ITP and coronary artery disease are a rare situation. These patients are treated with percutaneous, surgery or medical therapy. Our patient is 61 years old female who resting angina pectoris (Canada classification class 4). She has immun trombocytopenic purpura for 5 years. Her hematological investigation showed thrombocyte counts 40x10^9/L. We performed coronary angiography after hematology counsultation. Coronary angiography showed left main coronary artery ostial 99% stenosis, right coronary artery ostial 90% stenosis. At the same section, we implanted bare metal stent 4.0x12 mm for right coronary artery and 4.5x15 mm for left main coronary artey ostial lesions, respectly. Angina of the patient disaapeared and she was discharged next day. There was no any problems at 6th month outpatient control.

PDF

___

Gracia MC, Cebollero IC, Lezcano JS, et.al. Invasive treatment performed for acute myocardial infarction in a patient with immune thrombocytopenic purpura. Int J Cardiol. 2008;127:183-5

Fuchi T, Kondo T, Sase K, et.al. Primary percutaneous transluminal coronary angioplasty performed for acute myocardial infarction in a patient with idiopathic thrombocytopenic purpura. Jpn Circ J. 1999;63:133-6.

Kikuchi S, Hayashi Y, Fujioka S, et al. A case of intracoronary stent implanted for acute myocardial infarction in an elderly patient with idiopathic thrombocytopenic purpura. Nippon Ronen Igakkai Zasshi. 2002;39:88-93.

Hun-Jun P, Ki-Bae S, Pum Joon K, et al. Intracoronary stent deployment without antiplatelet agents in a patient with idiopathic thrombocytopenic purpura. Korean Circ J. 2007;37:87-90.

Russo A, Cannizzo M, Ghetti G, et al. Idiopathic thrombocytopenic purpura and coronary artery disease: comparison between coronary artery bypass grafting and percutaneous coronary interventionInteract. Cardiovasc Thorac Surg. 2011;13:153-7.

Renard D1, Cornillet L, Castelnovo G. Myocardial infarction after rituximab infusion. Neuromuscular Disorders. 2013;23:599-601.

Caputo RP, Abraham S, Churchill D.Transradial coronary stent placement in a patient with severe idiopathic autoimmune thrombocytopenic purpura. J Invasive Cardiol. 2000;12:365-8.

Sandeep K D, Edwin L, John F, et al. Acute ST elevation myocardial infarction in patients with immune thrombocytopenia purpura: a case report. Cardiol Res. 2011;2:42-5.

Estelle T, Harout Y, Donald M, James L. Two Cases and Review of the Literature: Primary Percutaneous Angiography and Antiplatelet Management in Patients with Immune. Thrombocytopenic Purpura. 2013;2013:174659.

Yagmur J, Cansel M, Acikgoz N et al. Multivessel coronary thrombosis in a patient with idiopathic thrombocytopenic purpura. Texas Heart Institute J. 2012;39:881-3.