Key result
Intracoronary artery retrograde thrombolysis with urokinase successfully restored TIMI grade 3 blood flow within 7 minutes in a diabetic patient with a 17-hour STEMI and massive thrombus burden.
Why the study?
The management of a large thrombus burden in patients with acute myocardial infarction and diabetes remains a worldwide problem.
Does intracoronary artery retrograde thrombolysis with urokinase improve coronary blood flow in a patient with STEMI, diabetes, and high thrombus burden?
Case Report (n=1)
No
Does intracoronary artery retrograde thrombolysis with urokinase improve coronary blood flow in a patient with STEMI, diabetes, and high thrombus burden?
Intracoronary artery retrograde thrombolysis with urokinase may be an effective and safe strategy for managing large thrombus burden in STEMI patients with diabetes.
Background: The management of a large thrombus burden in patients with acute myocardial infarction and diabetes is still a worldwide problem. Case presentation: A 74-year-old Chinese woman presented with ST-segment elevation myocardial infarction (STEMI) complicated with diabetes mellitus and hypertension. Angiography revealed massive thrombus formation in the mid-segment of the right coronary artery leading to vascular occlusion. The sheared balloon was placed far from the occlusion segment and urokinase (100,000 u) was administered for intracoronary artery retrograde thrombolysis, and thrombolysis in myocardial infarction (TIMI) grade 3 blood flow was restored within 7 min. At last, one stent was accurately implanted into the culprit's vessel. No-reflow, coronary slow flow, and reperfusion arrhythmia were not observed during this process. Conclusion: Intracoronary artery retrograde thrombolysis (ICART) can be effectively and safely used in patients with STEMI along with diabetes mellitus and hypertension, even if the myocardial infarction exceeds 12 h (REST or named ICART ClinicalTrials.gov number, ChiCTR1900023849).
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Shen et al. (2022) conducted a case report in ST-segment elevation myocardial infarction complicated with diabetes mellitus (n=1). Intracoronary artery retrograde thrombolysis (ICART) combined with percutaneous coronary intervention was evaluated on Restoration of TIMI grade 3 blood flow. Intracoronary artery retrograde thrombolysis with urokinase successfully restored TIMI grade 3 blood flow within 7 minutes in a diabetic patient with a 17-hour STEMI and massive thrombus burden.
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