Successful recanalization of an occluded coronary artery by percutaneous coronary intervention, systemic administration of tirofiban, a glycoprotein IIb/IIIa inhibitor, and intracoronary thrombolysis with alteplase.
A 51 year-old male was admitted to our institution with subacute inferior myocardial infarction. Coronary angiography showed thrombotic occlusion of the right coronary artery. Percutaneous coronary intervention including the delivery of 3 stents was unsuccessful (TIMI grade 0 flow). In addition to an ongoing systemic administration of tirofiban, a glycoprotein IIb/IIIa inhibitor, the patient received intracoronary thrombolysis (ICT) with alteplase (recombinant tissue type plasminogen activator, rt-PA). There was complete reperfusion on control angiography the following day (TIMI grade 3 flow); 7 months later, there was still TIMI grade 3 flow. To our knowledge, this is the first report on systemic administration of tirofiban combined with ICT.
Meyners
W
W
St.-Marien-Krankenhaus Siegen, Medizinische Klinik II-Kardiologie, Kampenstr. 51, 57072 Siegen, Germany. w.meyners@marienkrankenhaus.com
Peters
S
S
Trümmel
M
M
Koehler
B
B
D015906:Angioplasty, Balloon, Coronary; D003328:Coronary Thrombosis / Q000150:complications / Q000188:drug therapy* / Q000601:surgery*; D004359:Drug Therapy, Combination; D005343:Fibrinolytic Agents / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000209:etiology / Q000601:surgery*; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage; D020127:Recovery of Function; D015912:Thrombolytic Therapy / Q000379:methods*; D000077466:Tirofiban; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage*; D017211:Treatment Failure; D016896:Treatment Outcome; D014443:Tyrosine / Q000008:administration & dosage* / Q000031:analogs & derivatives*
D005343:Fibrinolytic Agents; D010975:Platelet Aggregation Inhibitors; D014443:Tyrosine; D010959:Tissue Plasminogen Activator; D000077466:Tirofiban