Key result
Sequential treatment combining intracoronary glycoprotein IIb/IIIa inhibitor, rheolytic thrombectomy, and transcatheter thrombus aspiration successfully managed a massive intracoronary thrombus.
Case Report (n=1)
This case illustrates the potential benefit of combining various mechanical strategies to treat massive intracoronary thrombus during STEMI intervention.
Hypothesis-generating for combined mechanical strategies in refractory STEMI thrombus; prospective trials needed before clinical adoption.
Thrombus-laden coronary lesions present a particular challenge to the interventional cardiologist. Despite the development of multiple strategies to attack this problem, lesions with angio-graphically visible thrombus still carry a high risk of complications when coronary intervention is attempted. The authors present a case of acute inferior ST elevation myocardial infarction with a massive thrombus in an ectatic right coronary artery. Sequential treatment with intra-coronary glycoprotein IIb/IIIa inhibitor, rheolytic thrombectomy with 2 different-sized catheters, and transcatheter thrombus aspiration with a Pronto aspiration catheter was required to achieve a satisfactory result. This case illustrates the potential benefit of combining various mechanical strategies to treat intracoronary thrombus.
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Carey et al. (2007) conducted a case report in Acute inferior ST elevation myocardial infarction with massive intracoronary thrombus (n=1). Sequential treatment with intracoronary glycoprotein IIb/IIIa inhibitor, rheolytic thrombectomy, and transcatheter thrombus aspiration was evaluated on Satisfactory angiographic result. Sequential treatment combining intracoronary glycoprotein IIb/IIIa inhibitor, rheolytic thrombectomy, and transcatheter thrombus aspiration successfully managed a massive intracoronary thrombus.
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