Anticoagulation Management During a Spinal Cord Stimulator Trial on a Patient With ST-Elevation Myocardial Infarction.

Pain medicine case reports Pub Date : 2024-03-01
Laert Rusha, Abhishek Yadav, Justin Li, Keith Austin Scarfo, Ross Barker, Peter Soukas
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Abstract

Background: Spinal cord stimulators (SCSs) are indicated for the treatment of many pain syndromes. They are often trialed prior to placement of a permanent implant. Patients on anticoagulation therapy are instructed to follow the American Society of Regional Anesthesia and Pain Medicine guidelines during this process.

Case report: Here we describe a unique case of a patient who had an SCS trial, followed by an ST-elevation myocardial infarction (STEMI) on day 4 postimplantation. After coronary revascularization, the patient started dual antiplatelet therapy, which posed significant for epidural hematoma with recent stimulator implantation.

Conclusions: The patient was bridged with intravenous antiplatelet agents prior to SCS trial removal and monitored closely. Our discussion will focus on all anticoagulation management of patients with a recent STEMI who had undergone a trial SCS implantation.

st段抬高型心肌梗死患者脊髓刺激器试验期间的抗凝治疗。
背景:脊髓刺激器(scs)适用于许多疼痛综合征的治疗。它们通常在植入永久植入物之前进行试验。在此过程中,接受抗凝治疗的患者应遵循美国区域麻醉和疼痛医学协会的指导方针。病例报告:在这里,我们描述了一个独特的病例,患者接受了SCS试验,随后在植入后第4天发生st段抬高心肌梗死(STEMI)。冠状动脉血运重建术后,患者开始双重抗血小板治疗,这对近期植入刺激器的硬膜外血肿有重要意义。结论:在SCS试验移除前,患者接受静脉抗血小板药物桥接治疗,并密切监测。我们的讨论将集中于近期STEMI患者的抗凝治疗,这些患者接受了实验性SCS植入。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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