Complex Antiplatelet Therapy Management in Patients Requiring Urgent Interventions for Pseudoachalasia and Esophageal Obstruction

TL;DR

This case report shows how IV cangrelor can help manage antiplatelet therapy in a patient with heart disease and esophageal blockage who cannot take oral medications.

Contribution

Demonstrates the use of IV cangrelor as a bridging therapy for antiplatelet management in patients with esophageal obstruction.

Findings

IV cangrelor was successfully used to prevent stent thrombosis in a patient requiring urgent endoscopic intervention.

The patient transitioned from oral clopidogrel to IV cangrelor before the procedure without complications.

IV antiplatelet therapy is a viable option for patients with esophageal obstructions who cannot tolerate oral drugs.

Abstract

This case report describes the use of intravenous (IV) cangrelor as a transient tool for antiplatelet bridging therapy in a 70-year-old male with coronary artery disease and esophageal strictures who underwent recent percutaneous coronary intervention (PCI) and subsequently required a pre-oral endoscopic myomectomy (POEM) procedure. The patient was switched from oral clopidogrel to IV cangrelor drip prior to the procedure, which was successful in preventing stent thrombosis. The case highlights the potential benefits of IV antiplatelet therapy in patients unable to tolerate oral medications in the setting of esophageal obstructions following recent coronary stent placement in a critical care setting.

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