A 65 years - old man with recurrent right sided TIAs and severe left ICA stenosis was undergoing stent placement.
He had been taking Aspirin and Clopidogrel and the ACT pre-procedure was ~300.
After heparinization with 5000 Units, a Zilver stent was deployed following pre-dilatation with a balloon.
Immediately after deployment thrombosis was noticed in the proximal part of the stent.
Immediately, intra-arterial Tirofiban was started and balloon angioplasty done.
After 15 min. there was complete reopening. Follow up Color doppler studies next day and at 1 nad 3 months showed complete patency of the stent.