Thrombotic occlusion of the left main coronary artery during coronary angiography.
A case of left main occlusion due to thrombus during coronary angiography is reported. This rare and extremely dangerous complication was successfully managed with resuscitation maneuvers, hemodynamic support, urgent balloon angioplasty plus stent implantation, anticoagulation with heparin and potent therapy directed at preventing platelet aggregation. The thrombus most likely detached from the arterial sheath, although coexisting circumstances, such as the use of non-ionic contrast or a transient hypercoagulable state, may have had an influence. A careful technique during the procedure is probably the most effective preventive measure.
Sanz
A Javier
AJ
Servicio de Cardiología, Hospital Universitario Doce de Octubre, Madrid, Spain. hosoctubre@retemail.es
Hernández
Felipe
F
Tascón
Juan C
JC
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation / Q000379:methods*; D003131:Combined Modality Therapy; D017023:Coronary Angiography / Q000009:adverse effects* / Q000379:methods; D003326:Coronary Circulation; D003328:Coronary Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy*; D017548:Echocardiography, Transesophageal; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D005500:Follow-Up Studies; D006801:Humans; D008946:Mitral Valve Stenosis / Q000000981:diagnostic imaging / Q000601:surgery; D011300:Preoperative Care; D018570:Risk Assessment; D015607:Stents; D016896:Treatment Outcome
D005343:Fibrinolytic Agents