Prevention and Management of Stent Thrombosis after Complex Coronary Stenting in Patients with Risk of Gastrointestinal Bleeding

Shigenori Ito
Division of Cardiology, Nagoya City East Medical Center, Aichi-ken, Japan

Series: Cardiology Research and Clinical Developments
BISAC: MED010000

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Volume 10

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Volume 2

Volume 3

Special issue: Resilience in breaking the cycle of children’s environmental health disparities
Edited by I Leslie Rubin, Robert J Geller, Abby Mutic, Benjamin A Gitterman, Nathan Mutic, Wayne Garfinkel, Claire D Coles, Kurt Martinuzzi, and Joav Merrick

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Complex cases with gastrointestinal bleeding (GIB) risk are very challenging in terms of balancing the risk of ischemia and bleeding after coronary stent deployment, and concerns have been raised about the optimal anti-platelet therapy in such cases. An interventional strategy is also very important to prevent stent thrombosis with short term anti-platelet therapy. However, a dilemma is present with respect to these cases because complex cases always have a higher incidence of restenosis and/or late stent thrombosis without drug-eluting stents which need long-term dual anti-platelet therapy (DAPT). This book discusses the management of patients undergoing complex percutaneous coronary interventions (PCI) who may be at risk of gastrointestinal bleeding. (Imprint: Nova Biomedical)

Abstract

Introduction

Classification and management of patients undergoing PCI with GIB risk

Patient and lesion characteristics with high risk of GIB

Lesion characteristics with high risk of restenosis and subsequent stent thrombosis

Procedural factors including coronary stent selection

Management of anti-platelet therapy in cases of GIB in patients after stent implantation

Aspirin withdrawal and stent thrombosis

Resistance to anti-platelet drugs and how to decide upon the measurement of platelet reactivity in high risk patients

Clopidogrel and PPIs interactions

Conclusion

References

Index

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