Failure of enoxaparin during coronary stenting: a case report

Area of Science:

• Cardiology
• Interventional Cardiology
• Pharmacology

Background:

• Percutaneous coronary intervention (PCI) is a common procedure for coronary insufficiency.
• Low-molecular-weight heparin (LMWH) is frequently used for anticoagulation during PCI.
• Glycoprotein IIb/IIIa receptor blockers are potent antiplatelet agents used in high-risk PCI cases.

Observation:

• A 90-year-old male patient received LMWH prior to coronary stenting.
• Coronary stenting was performed 6 hours after the last LMWH dose.
• The procedure was complicated by significant intrastent clot formation.

Findings:

• Intrastent thrombosis occurred despite LMWH administration.
• The timing of LMWH administration relative to the procedure may be a factor.
• The absence of a glycoprotein IIb/IIIa receptor blocker was noted during the event.

Implications:

• LMWH monotherapy might be insufficient for anticoagulation in certain PCI scenarios.
• Combining LMWH with glycoprotein IIb/IIIa inhibitors may be crucial for preventing intrastent thrombosis.
• Further research is needed to optimize anticoagulation strategies during PCI to minimize thrombotic complications.