Date | 06/2014 | 10/2015 | 03/2018 | 08/2019 |
---|---|---|---|---|
AMI/Coronary artery | STEMI/RCA | STEMI/RCA | STEMI/RCA | STEMI/RCA |
Angiographic Findings | 100% occlusion of RCA | Thrombosis of RCA | Acute thrombus; severe in‐stent‐restenosis at the previous distal stent at bifurcation of rPDA & rPLV | Acute thrombus of RCA |
Treatment | Thrombectomy + DESx1 to RCA; DAPT + warfarin. Warfarin switched to rivaroxaban after 6 months | Thrombectomy + DESx3 to RCA; DAPT + warfarin | Angioplasty to rPLV + DESx1; DAPT + therapeutic enoxaparin | Intravascular aspiration; clopidogrel + rivaroxaban |
Comorbid VTE | Right common femoral vein DVT | Left gastrocnemius vein DVT | None | None |
Preceding Anticoagulation | None | Rivaroxaban stopped due to financial burden 1 month prior | Warfarin stopped 1 week prior for colonoscopy | Therapeutic enoxaparin stopped 10 days prior due to expanding gluteal hematoma with lower extremity paresthesia and acute anemia |
Comorbid Malignancy | Gleason 7 T3bN1M0 prostate cancer | Bone metastatic prostate cancer | None (PSA undetectable, not on active treatment) | None (PSA undetectable, not on active treatment) |
AMI = acute myocardial infarction; STEMI = ST‐elevation myocardial infarction; RCA = right coronary artery
rPDA = right posterior descending artery; rPLV = right posterior‐lateral ventricular branch
DES = drug‐eluting stent; DAPT = dual‐antiplatelet therapy; VTE = venous thromboembolism
DVT = deep vein thrombosis; PSA = prostate‐specific antigen