| Japanese |
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| Title | PCI中に発生した冠動脈内血栓に対しアルガトロバンが奏功した1例 |
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| Subtitle | 症例 |
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| Authors | 田口哲也, 星崎洋, 塚田直史, 佐々木健人, 水沼寛代, 村田誠, 宮石裕介, 簡伯憲, 小暮真也, 河口廉, 村上淳, 安達仁, 外山卓二, 大島茂 |
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| Authors(kana) | |
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| Organization | 群馬県立心臓血管センター |
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| Journal | 循環制御 |
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| Volume | 32 |
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| Number | 2 |
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| Page | 90-94 |
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| Year/Month | 2011/8 |
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| Article | 報告 |
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| Publisher | 日本循環制御医学会 |
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| Abstract | 「要旨」症例は58歳の男性. 断続する胸痛が出現し, 不安定狭心症の診断で入院. 冠動脈造影で左回旋枝と右冠動脈にそれぞれ90%狭窄を認めた. 抗血小板薬の内服およびヘパリン・硝酸薬の持続点滴で経過観察後, 左回旋枝に対し経皮的冠動脈形成術を行った. 病変はびまん性で薬剤溶出性ステントを2本留置した. 2本目のステントを留置した直後より冠動脈内に血栓が出現した. 血管内超音波上ステントmalappositionは無く, 血小板数の低下も認めなかった. ACTを250秒以上に保ち, 繰り返しステント内拡張術を行ったが, その都度血栓が出現した. そこで, アルガトロバンを投与したところ, 血栓が消失した. ヘパリン起因性血小板減少症を示唆する所見は無かったが, 臨床的にアルガトロバンが有効であった. 「緒言」急性冠症候群の患者に経皮的冠動脈形成術(percutaneous coronary intervention: PCI)を施行する際, しばしば手技中に冠動脈内血栓の発生を認めることがある. |
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| Practice | 基礎医学・関連科学 |
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| Keywords | PCI, HIT, argatroban |
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| English |
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| Title | The Effectiveness of Argatroban for Coronary Thrombus during PCI |
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| Subtitle | |
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| Authors | Tetsuya Taguchi, Hiroshi Hoshizaki, Naofumi Tsukada, Takehito Sasaki, Hiroyo Mizunuma, Makoto Murata, Yusuke Miyaishi, Hakuken Kan, Shinya Kogure, Eiji Yamashita, Ren Kawaguchi, Jun Murakami, Hitoshi Adachi, Takuji Toyama, Shigeru Oshima |
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| Authors(kana) | |
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| Organization | Department of Cardiology, Gunma Prefectural Cardiovascular Center |
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| Journal | Circulation Control |
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| Volume | 32 |
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| Number | 2 |
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| Page | 90-94 |
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| Year/Month | 2011/8 |
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| Article | Report |
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| Publisher | Japan Society of Circulation Control in Medicine |
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| Abstract | A 58-year-old man was admitted to our hospital because of continual chest pain. The coronary angiography showed severe stenosis of the mid LCX and mid RCA. He was administered dual-antiplatelet therapy and received an infusion of heparin and nitroglycerin. We performed elective percutaneous coronary intervention (PCI) for the mid LCX. Two PES (3.0/28+3.5/16) were implanted on LCX. After stenting, coronary thrombus appeared suddenly. We performed intravascular ultrasound (IVUS) and recognized much of thrombus and no finding of dissection and stent malapposition. Platelets were not decreased. While plain old balloon angioplasty (POBA) was performed repeatedly under intra-aortic balloon pumping (IABP), coronary thrombus appeared. After argatroban was administered, coronary thrombus disappeared completely. We experienced a case which argatroban was clinically effective in spite of no evidence of heparin-induced thrombocytopenia. |
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| Practice | Basic medicine |
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| Keywords | PCI, HIT, argatroban |
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