Key result
Urokinase infusion via the Dispatch catheter successfully lysed angiographic thrombus in all 4 patients prior to coronary stenting without complications.
Why the study?
Does urokinase infusion via the Dispatch catheter lyse intracoronary thrombus prior to stenting in patients with angiographic evidence of thrombus?
Case Report (n=4)
Does urokinase infusion via the Dispatch catheter lyse intracoronary thrombus prior to stenting in patients with angiographic evidence of thrombus?
Lysis of intracoronary thrombus using urokinase via the Dispatch infusion catheter prior to stenting is feasible and appears safe in a small case series.
Answers are grounded in this paper and cite their sources.
Should not change practice in thrombus management; leaves open the need for randomized trials to assess efficacy and outcomes.
The presence of angiographic evidence of thrombus is generally thought to be a contraindication to coronary stent placement. This report describes four patients in whom angiographic thrombus was lysed using the Dispatch infusion catheter prior to coronary stenting. Urokinase was infused via the Dispatch catheter with resolution of angiographic evidence of thrombus in all cases. No complications were encountered using this technique, and all patients had excellent angiographic results after stenting. We conclude that lysis of intracoronary thrombus using the Dispatch infusion catheter is feasible and appears safe in this small study. Further trials are needed to determine if this technique reduces the acute stent thrombosis rate compared to other techniques for stent deployment in the presence of angiographic evidence of thrombus.
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Kerensky et al. (1996) conducted a case report in Angiographic evidence of thrombus prior to coronary stenting (n=4). Urokinase infusion via the Dispatch infusion catheter was evaluated on Resolution of angiographic evidence of thrombus. Urokinase infusion via the Dispatch catheter successfully lysed angiographic thrombus in all 4 patients prior to coronary stenting without complications.
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