Usefulness of a 6 fr right judkins catheter for mechanically extracting a massive intracoronary thrombus from an ectasic right coronary artery: a report on two different cases of thrombectomy.
In order to bail out the slow-flow phenomenon (slow flow) created by a massive thrombus in an ectasic right coronary artery, a thrombus was mechanically extracted with a 6 Fr right Judkins (JR) catheter, which proved to be more useful than a usual thrombectomy using a Rescue PT system catheter (Rescue). In case 1, the Rescue was used in combination with thrombolysis but failed to alleviate the slow flow that was implicated in a large infarction. On the other hand, in case 2, aggressive thrombectomy with a 6 Fr JR catheter with an 8 Fr Amplatz guiding catheter successfully extracted the massive intracoronary thrombus, restoring good coronary flow. Therefore, mechanical extraction with a 6 Fr JR catheter is safe and useful in cases of massive thrombus when diffuse coronary artery ectasia complicates an acute myocardial infarction. In addition, this method should be applicable to cases of acute coronary syndrome with massive thrombus.
Onoda
Satoru
S
Division of Cardiology, Saitama Cardiovascular and Respiratory Center, Japan.
Mutoh
Makoto
M
Ishikawa
Tetsuya
T
Sakamoto
Hiroshi
H
Yamaguchi
Junichi
J
Okada
Hisayuki
H
Tsurusaki
Tetsushi
T
Kubota
Takeyuki
T
Takizawa
Shinichiro
S
Yagi
Hidenori
H
Mori
Chikara
C
Nagasawa
Hidetaka
H
Shibata
Takahiro
T
Yoshida
Satoru
S
Imai
Kamon
K
Horie
Toshinobu
T
Mochizuki
Seibu
S
D000328:Adult; D000368:Aged; D006328:Cardiac Catheterization / Q000295:instrumentation; D003327:Coronary Disease / Q000150:complications; D003328:Coronary Thrombosis / Q000150:complications / Q000628:therapy*; D004108:Dilatation, Pathologic / Q000150:complications; D005260:Female; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000209:etiology / Q000628:therapy*; D015425:Myocardial Reperfusion / Q000295:instrumentation*; D017131:Thrombectomy / Q000295:instrumentation*; D016896:Treatment Outcome