A case of successful reperfusion through a combination of intracoronary thrombolysis and aspiration thrombectomy in ST-segment elevation myocardial infarction associated with an ectatic coronary arteryReportar como inadecuado




A case of successful reperfusion through a combination of intracoronary thrombolysis and aspiration thrombectomy in ST-segment elevation myocardial infarction associated with an ectatic coronary artery - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

BMC Cardiovascular Disorders

, 17:94

Coronary artery disease

Abstract

BackgroundLarge thrombus burdens in ectatic coronary arteries that remain after aspiration thrombectomy can negatively impact outcomes following percutaneous coronary interventions in patients with acute myocardial infarction.

Case presentationA 53-year-old man presented with ST-segment elevation myocardial infarction STEMI. Coronary angiography revealed an ectatic right coronary artery RCA that was completely occluded in the mid portion by a large amount of thrombus. Catheter-directed intracoronary thrombolysis with alteplase led to recovery of coronary blood flow, which multiple attempts of aspiration thrombectomy had failed to achieve. Coronary angiography 9 days later showed good blood flow and insignificant stenosis remaining in the RCA; this had completely resolved in 6 months’ follow-up coronary angiography.

ConclusionCatheter-directed intracoronary thrombolysis can be performed effectively and safely when repeat aspiration thrombectomy fails to produce satisfactory coronary reperfusion in STEMI patients with large thrombus burdens in ectatic coronary arteries.

KeywordsMyocardial infarction Aspiration thrombectomy Intracoronary thrombolysis Coronary ectasia Case report AbbreviationsCAGCoronary angiography

IVUSIntravascular ultrasound

MLAMinimal lumen area

PCIPrimary percutaneous coronary intervention

PDAPosterior descending artery

RCARight coronary artery

STEMIST-elevation myocardial infarction

TIMIThrombolysis in myocardial infarction





Autor: Yonggu Lee - Eunjin Kim - Bae Keun Kim - Jeong-Hun Shin

Fuente: https://link.springer.com/







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