Successful revascularization of coronary artery occluded by massive intracoronary thrombi with alteplase and percutaneous coronary intervention.
A 67-year-old man was admitted to our institution with sudden and persistent chest pain for 3 days. Coronary angiography showed massive thrombotic occlusion of the right coronary artery. The patient received intracoronary thrombolysis with alteplase (recombinant tissue-type plasminogen activator, rt-PA). On repeated angiography, there was marked resolution of intracoronary thrombus. After percutaneous coronary intervention with stent implantation, the final result was complete revascularization of the right coronary artery (TIMI grade 3 distal flow). This case demonstrates that intracoronary rt-PA can result in local thrombus reduction in patients undergoing PCI, especially with a large thrombus burden.
Kim
Jeong Su
JS
Department of Internal Medicine, Division of Cardiology, Pusan National University School of Medicine, PNU Yangsan Hospital, Yangsan, Korea.
Kim
June Hong
JH
Jang
Hyung Ha
HH
Lee
Yong Whan
YW
Song
Sung Gook
SG
Park
Ju Hyun
JH
Chun
Kook Jin
KJ
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D003328:Coronary Thrombosis / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D003331:Coronary Vessels / Q000187:drug effects* / Q000473:pathology*; D006801:Humans; D008297:Male; D020127:Recovery of Function; D015912:Thrombolytic Therapy; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D016896:Treatment Outcome
D010959:Tissue Plasminogen Activator