May Watchful Waiting Strategy Be Benefit In Patients With Coronary Thrombus Receiving BEP Chemotherapy?

Öz

The relationship between the combination of bleomycin-etoposide-cisplatin, a chemotherapeutic treatment option used in testicular carcinomas, and acute thrombotic events has been previously described. Acute coronary syndromes associated with this treatment have been frequently reported. The differences in the underlying mechanisms that lead to coronary events suggest that the treatment options may vary in these situations. The decision regarding the right treatment option for the patient sometimes emerges after a relatively long process that requires patience. In this event, which occurs without atherosclerosis and involves vasospasm and thrombus formation, a conservative approach may be beneficial. A 42-year-old individual diagnosed with testicular cancer who did not have any cardiac risk factors was diagnosed with acute coronary syndrome. Since no atherosclerotic background is observed on coronary angiography, coronary intervention is postponed. In this case, the management of the patient will be discussed with a focus on medical treatment without any coronary intervention.

Anahtar Kelimeler

• BEP regimen
• thrombus
• acute coronary syndrome
• testicular carcinoma
• Combination chemotherapy

BEP TEDAVİSİ ALAN KORONER TROMBÜSLÜ HASTALARDA YAKIN İZLEM STRATEJİSİ FAYDALI OLABİLİR Mİ?

Öz

Testis karsinomlarında kullanılan bir kemoterapötik tedavi seçeneği olan bleomisin-etoposit-sisplatin kombinasyonunun akut trombotik olaylarla ilişkisi daha önce açıklanmıştır. Bu tedaviyle ilişkili akut koroner sendromlar sıklıkla bildirilmiştir. Koroner olaylara yol açan altta yatan mekanizmalardaki farklılıklar, bu durumlarda tedavi seçeneklerinin değişebileceğini düşündürmektedir. Hasta için doğru tedavi seçeneğine ilişkin karar bazen sabır gerektiren nispeten uzun bir sürecin ardından ortaya çıkar. Ateroskleroz olmadan gerçekleşen ve vazospazm ve trombüs oluşumunu içeren bu olayda konservatif bir yaklaşım faydalı olabilir. 42 yaşında, kardiyak risk faktörü olmayan testis kanseri tanısı konulan bir bireye akut koroner sendrom tanısı konuldu. Koroner anjiyografide aterosklerotik bir zemin gözlenmediği için koroner müdahale ertelendi. Bu durumda hastanın yönetimi, koroner müdahale olmaksızın tıbbi tedaviye odaklanılarak tartışılacaktır.

Anahtar Kelimeler

• BEP rejimi
• trombüs
• akut koroner sendrom
• testis karsinomu
• Kombinasyon kemoterapisi

Kaynakça

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