Architecture of the thrombi removed from coronary artery bypass grafts in a patient with acute myocardial infarction.
Using scanning electron microscopy we analyzed thrombotic material removed from coronary bypass grafts in a 57-year-old woman with multilevel atherosclerosis presenting with acute myocardial infarction (AMI). A white thrombotic material removed from the marginal branch bypass that contained large amounts of activated platelets displaying pseudopodia clearly visible at a higher magnification with a relatively low amount of fibrin. The other thrombus obtained from the right posterior descendent branch (RPD) bypass showed a highly organized fibrin structure composed of thicker fibers with low amounts of cellular components. Our findings indicate that the thrombus structure is different in AMI patients in whom the infarct-related vessel is vein anastomosis compared to those with a native coronary artery occluded. These findings help explain resistance of such thrombi to fibrinolysis and faster plaque growth related to fibrin accumulation.
Marek
Grzegorz
G
Institute of Cardiology, Jagiellonian University School of Medicine, 80 Pradnicka Str, 31-202 Krakow, Poland. gmarek@poczta.onet.pl
Kablak-Ziembicka
Anna
A
Stepien
Ewa
E
Undas
Anetta
A
D050197:Atherosclerosis; D048430:Cell Shape; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D005260:Female; D005337:Fibrin / Q000648:ultrastructure; D006801:Humans; D008855:Microscopy, Electron, Scanning; D008875:Middle Aged; D009203:Myocardial Infarction; D015539:Platelet Activation; D011554:Pseudopodia; D013927:Thrombosis / Q000473:pathology*
D005337:Fibrin