Persistent and proximal migration of a large coronary thrombus during percutaneous coronary intervention in the setting of acute Q-wave myocardial infarction.
We describe a patient with an acute inferior myocardial infarction. Patient was taken to the cardiac catheterization laboratory for primary angioplasty. Angiography revealed 100% occluded proximal right coronary artery (RCA). After initial balloon angioplasty of the occluded RCA, a very large mobile thrombus was seen in the proximal RCA. Despite multiple stenting, suctioning through the guide catheter lumen, and intracoronary thrombolytic therapy, the thrombus persisted and migrated proximally after each stenting. However, patient did well despite of persistent large thrombus burden in the proximal RCA on aggressive antithrombotic treatment.
Movahed
Mohammad-Reza
MR
Division of Cardiology, Department of Medicine, University of California, Irvine Medical Center, Orange, CA 92868-4080, USA. mmovahed@uci.edu
D000368:Aged; D000800:Angioplasty, Balloon; D003131:Combined Modality Therapy; D017023:Coronary Angiography; D003328:Coronary Thrombosis / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000209:etiology*; D015607:Stents; D015912:Thrombolytic Therapy