Maintenance of Drug-Eluting Stent Patency Through Use of a Cangrelor Infusion in the Clinical Setting of Massive Pulmonary Hemorrhage and Venoarterial Extracorporeal Membrane Oxygenation.

We report ultra-short–acting parenteral P2Y12 inhibitor, cangrelor, for maintenance of fresh drug-eluting stent patency concurrent pulmonary hemorrhage and cardiogenic shock requiring central venoarterial extracorporeal membrane oxygenation. In the setting of stent placement after acute coronary syndrome, standard of care includes indefinite aspirin use plus 12 months of P2Y12 inhibitor to avoid in-stent thrombosis. Cangrelor therapy, with its downregulation of platelet activation and aggregation, was initiated at one-half the recommended percutaneous coronary intervention dosing (2 mcg/kg/min) and maintained patency during central venoarterial extracorporeal membrane oxygenation.