Prolonged systemic delivery of tirofiban in a thrombus-laden saphenous vein graft.
Results from previous trials have shown conflicting results from local delivery of thrombolytic agents to diminish thrombus burden before intervention in native coronary arteries and saphenous vein grafts. We described a patient with an acute coronary syndrome who was treated for 24 hours with systemic tirofiban (Aggrastat), a glycoprotein IIb/IIIa inhibitor, for the treatment of a degenerated saphenous vein graft with a TIMI grade 4 thrombus (large-sized thrombus). Angiographic evaluation 48 hours later revealed complete resolution of the thrombus with normal coronary blood flow.
Division of Invasive Cardiology, Rambam Medical Center, The Technion-Israel Institute of Technology, Haifa, Israel. gruberg67@hotmail.com
Luis
L
Gruberg
Shlomo
S
Amikam
D000368:Aged; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000601:surgery; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging / Q000188:drug therapy*; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000037:antagonists & inhibitors*; D011859:Radiography; D012501:Saphenous Vein / Q000502:physiology / Q000637:transplantation; D013923:Thromboembolism / Q000000981:diagnostic imaging / Q000188:drug therapy*; D000077466:Tirofiban; D014443:Tyrosine / Q000008:administration & dosage* / Q000031:analogs & derivatives
D005343:Fibrinolytic Agents; D019039:Platelet Glycoprotein GPIIb-IIIa Complex; D014443:Tyrosine; D000077466:Tirofiban