Intracoronary Thrombolysis and Delayed Percutaneous Coronary Intervention for the Treatment of Large Coronary Thrombi in a Patient with Polycythemia Vera.
10.3904/kjm.2014.87.6.728
- Author:
Hye Young LEE
1
;
Byung Ok KIM
;
Young Sup BYUN
;
Choong Won GOH
;
Jeong Hoon KIM
Author Information
1. Division of Cardiology, Department of Internal Medicine, Sanggye Paik Hospital, Inje University, Seoul, Korea. jhkimmd@paik.ac.kr
- Publication Type:Case Report
- Keywords:
Thrombolytic therapy;
Myocardial infarction;
Percutaneous coronary intervention
- MeSH:
Aged;
Arteries;
Coronary Angiography;
Humans;
Male;
Myocardial Infarction;
Percutaneous Coronary Intervention*;
Polycythemia Vera*;
Thrombectomy;
Thrombolytic Therapy;
Thrombosis;
Urokinase-Type Plasminogen Activator
- From:Korean Journal of Medicine
2014;87(6):728-732
- CountryRepublic of Korea
- Language:English
-
Abstract:
The benefit of thrombus aspiration during percutaneous coronary intervention in patients with acute myocardial infarction (AMI) is well established; however, the optimal management strategy for patients with a large thrombus burden after repeated thrombectomy (i.e., "failed" thrombectomy) is unknown. Here, we report the case of a 67-year-old male with polycythemia vera who was treated with intracoronary thrombolytic therapy in combination with mechanical thrombectomy. Repeated aspiration thrombectomy did little to reduce the coronary thrombus burden; thus, intracoronary urokinase infusions were applied to the thrombus-containing lesion. Repeat coronary angiography 4 days later revealed markedly improved antegrade flow in the infarct-related artery, and successful revascularization was performed. This case demonstrates the potential utility of intracoronary thrombolytic therapy for select AMI patients with a large thrombus burden who are in a hypercoagulable state.
