Bivalirudin as rescue therapy for suspected heparin resistance and recurrent intra-procedural stent thrombosis during complex percutaneous coronary intervention: a case report - Takeaways - MDSpire

Bivalirudin as rescue therapy for suspected heparin resistance and recurrent intra-procedural stent thrombosis during complex percutaneous coronary intervention: a case report

  • By

  • Xiang Wang

  • Miao Dai

  • July 9, 2026

  • 0 min

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  • 1

    Heparin resistance during PCI can lead to significant thrombotic complications despite high doses of unfractionated heparin.

  • 2

    A case study demonstrated that switching to bivalirudin effectively achieved therapeutic anticoagulation in a patient with suspected heparin resistance.

  • 3

    The patient experienced recurrent intra-stent thrombosis during PCI, necessitating multiple interventions and anticoagulation adjustments.

  • 4

    Bivalirudin resulted in a rapid increase in activated clotting time and marked reduction in thrombus burden within 10 minutes.

  • 5

    The bivalirudin infusion was stopped after 2 hours due to acute epigastric pain, but no significant gastrointestinal bleeding occurred.

Original Source(s)

Bivalirudin as rescue therapy for suspected heparin resistance and recurrent intra-procedural stent thrombosis during complex percutaneous coronary intervention: a case report

  • by Xiang Wang, Miao Dai

  • July 9, 2026

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