高胱胺酸血症為一易導致栓塞之前驅因子，臨床上可造成冠狀動脈心臟病,心肌梗塞，深層靜脈栓塞，腦中風，和肺動脈栓塞等疾病。我們報告一位高胱胺酸血症之病患於冠狀動脈氣球擴張術及支架置放後三天發生急性支架栓塞合併急性心肌梗塞及兩條冠狀動脈同時阻塞. 此為一極為罕見及非常危急之臨床急症。本文除討論包括高胱胺酸血症在內所有可能造成急性支架栓塞的原因外，並探討臨床上如何處理及預防如此罕見之臨床急症。

Hyperhomocysteinemia is a prothrombotic disorder that has recently been increasinglyrecognized. Hyperhomocysteinemia itself may increase the incidence of cardiovascular disease,including coronary artery disease, myocardial infarction, deep-vein thrombosis, thromboembolicstroke, and a pulmonary embolism.Herein, we report on a 63-year-oldmalewho developed suddenonset of severe chest pain 3 days after percutaneous transluminal coronary angioplasty (PTCA)and stenting for the right coronary artery (RCA) and left circumflex coronary artery (LCX). Anelectrocardiogram showed ST elevation in the inferior-lateral leads, and acute myocardialinfarction was the impression. Coronary angiography showed acute stent thrombosis and totalocclusion of the RCAand LCX. Emergent PTCA and further stenting of the RCAand LCX restoredthe coronary flow, and the chest pain was relieved. Hyperhomocysteinemia, chronic renalinsufficiency, and mild depletion of the vitamin B12 level were noted in this patient. We discussthe possible causes of the acute stent thrombosis, including hyperhomocysteinemia, in this patientand the strategy for treating and preventing such a rarely seen critical emergent condition.