Titre
Caplacizumab for treating subacute intra-stent thrombus occurring despite efficacious double anti-platelet treatment and anticoagulation: a case report.
Type
étude de cas
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
Stalder, G.
Auteure/Auteur
Chatte, A.
Auteure/Auteur
De Rossi, N.
Auteure/Auteur
Yerly, P.
Auteure/Auteur
Alberio, L.
Auteure/Auteur
Eeckhout, E.
Auteure/Auteur
Éditeur(s)
Vrachatis, Dimitrios A
Gragnano, Felice
Hartley, Adam
Cankovic, Milenko Zoran
Spinthakis, Nikolaos
Waight, Michael
Liens vers les personnes
Liens vers les unités
ISSN
2514-2119
Statut éditorial
Publié
Date de publication
2023-02
Volume
7
Numéro
2
Première page
ytac497
Peer-reviewed
Oui
Langue
anglais
Notes
Publication types: Case Reports
Publication Status: epublish
Publication Status: epublish
Résumé
Acute and subacute stent thromboses are a rare complication associated with high mortality and morbidity occurring in ∼1.5% of patients treated with primary percutaneous intervention for ST-elevation myocardial infarction (STEMI). Recent publications describe a potential role of the von Willebrand factor (VWF) in thrombus formation at sites of critical coronary stenosis in STEMI.
We describe a 58-year-old woman with STEMI at initial presentation, who suffered subacute stent thrombosis despite good stent expansion, efficacious dual antiplatelet therapy, and therapeutic anticoagulation. Because of very high VWF values, we administered N-acetylcysteine in order to depolymerize VWF, but the drug was not well tolerated. Since the patient was still symptomatic, we used caplacizumab in order to prevent VWF from interacting with platelets. Under this treatment, the clinical and angiographic course was favourable.
Considering a modern view of intracoronary thrombus pathophysiology, we describe an innovative treatment approach, which eventually ended in a favourable outcome.
We describe a 58-year-old woman with STEMI at initial presentation, who suffered subacute stent thrombosis despite good stent expansion, efficacious dual antiplatelet therapy, and therapeutic anticoagulation. Because of very high VWF values, we administered N-acetylcysteine in order to depolymerize VWF, but the drug was not well tolerated. Since the patient was still symptomatic, we used caplacizumab in order to prevent VWF from interacting with platelets. Under this treatment, the clinical and angiographic course was favourable.
Considering a modern view of intracoronary thrombus pathophysiology, we describe an innovative treatment approach, which eventually ended in a favourable outcome.
PID Serval
serval:BIB_18F8C049C796
PMID
Open Access
Oui
Date de création
2023-02-21T12:11:30.005Z
Date de création dans IRIS
2025-05-20T17:17:42Z
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Nom
ytac497.pdf
Version du manuscrit
published
Licence
https://creativecommons.org/licenses/by-nc/4.0
Taille
429.76 KB
Format
Adobe PDF
PID Serval
serval:BIB_18F8C049C796.P001
URN
urn:nbn:ch:serval-BIB_18F8C049C7960
Somme de contrôle
(MD5):4fa36e7641d890b0ec4df105e312f232