Stent thrombosis caused by metal allergy complicated by protein S deficiency and heparin-induced thrombocytopenia: A case report and review of the literature

Takao Konishi, Tadashi Yamamoto, Naohiro Funayama, Beni Yamaguchi, Seiichiro Sakurai, Hiroshi Nishihara, Koko Yamazaki, Yusuke Kashiwagi, Yasuki Sasa, Mitsuru Gima, Hideichi Tanaka, Daisuke Hotta, Kenjiro Kikuchi

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2 Citations (Scopus)

Abstract

A 43-year-old woman recipient of a bare metal coronary stent during an acute anterior myocardial infarction was repeatedly hospitalized with recurrent stent thrombosis (ST) over the following 3 years. Emergent coronary angiography showed a thrombus in the in-stent segment of the proximal left anterior descending artery. We repeatedly aspirated the thrombus, which immediately reformed multiple times. The discontinuation of heparin and administration of thrombolytics and argatroban, followed by repeated balloon dilatations, ended the formation of new thrombi. The patient was found to be allergic to nickel, protein S deficient and carrier of heparin-induced thrombocytopenia antibody. We discuss this case in the context of a) literature pertaining to acute coronary syndromes in the young, and b) the detailed investigations needed to identify thrombotic risk factors. Steroids may be effective to prevent recurrent ST caused by stent allergy.

Original languageEnglish
Article number25
JournalThrombosis Journal
Volume13
Issue number1
DOIs
Publication statusPublished - 2015 Jul 23
Externally publishedYes

Keywords

  • Heparin-induced thrombosis
  • Metal allergy
  • Protein S deficiency
  • Stent thrombosis

ASJC Scopus subject areas

  • Hematology

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    Konishi, T., Yamamoto, T., Funayama, N., Yamaguchi, B., Sakurai, S., Nishihara, H., Yamazaki, K., Kashiwagi, Y., Sasa, Y., Gima, M., Tanaka, H., Hotta, D., & Kikuchi, K. (2015). Stent thrombosis caused by metal allergy complicated by protein S deficiency and heparin-induced thrombocytopenia: A case report and review of the literature. Thrombosis Journal, 13(1), [25]. https://doi.org/10.1186/s12959-015-0055-z