Abstract | BACKGROUND: CASE SUMMARY: A 70-year-old man presented to our hospital with stent thrombosis due to non-absorption of antiplatelet agents, 3 days after an elective percutaneous intervention to the right coronary artery. The patient, who had had a laparoscopic high anterior resection due to previous colorectal cancer, had noticed tablets passing whole into his colostomy bag. Repeat balloon angioplasty and stenting were performed and the patient received further antiplatelet therapy in a crushed form. DISCUSSION:
Drug absorption in the gastrointestinal tract is altered when a significant length of the gut has been resected. Reduced intestinal luminal transit time and insufficient contact time with intestinal mucosa leads to reduced bioavailability of drugs and increased risk of stent thrombosis. The aetiology of stent thrombosis can be investigated with intravascular imaging techniques and platelet function testing. Management includes using different drug formulations and doses and monitoring the outcomes of therapy. In some cases, it may also be appropriate to involve a gastroenterology team, preferably in the multidisciplinary environment of an intestinal rehabilitation centre.
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Authors | Atifur Rahman, Sophia Wong |
Journal | European heart journal. Case reports
(Eur Heart J Case Rep)
Vol. 3
Issue 3
Pg. ytz119
(Sep 2019)
ISSN: 2514-2119 [Electronic] England |
PMID | 31660492
(Publication Type: Case Reports)
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Copyright | © The Author(s) 2019. Published by Oxford University Press on behalf of the European Society of Cardiology. |