A patient presented with inferior STEMI and a large right coronary artery thrombus. Aspiration attempts with an aspiration catheter, aspiration through a guide catheter extension, and retrieval using a Filterwire failed. The thrombus embolized distally compromising distal flow and laser failed to improve the flow. The patient had multiple episodes of ventricular fibrillation requiring defibrillation. He eventually stabilized on an epinephrine drip, obviating the need for inserting a right ventricular support device.
In cases of large intracoronary thrombus, conservatibve management with antithrombotic therapy (usually glycoprotein IIb/IIIa inhibitors and heparin) may allow resolution of the thrombus within 2-3 days, reducing the risk of embolization during PCI.
Негізгі бет Case 35: PCI Manual- Large RCA thrombus
Пікірлер: 36