title: Successful treatment for refractory coronary thrombus with scoring balloon angioplasty.
abstract: A female with chronic atrial fibrillation presented with an acute myocardial infarction. The angiogram revealed total occlusion of the right coronary artery. A combined strategy using intracoronary thrombolysis, aspiration catheter, plain old balloon angioplasty, and "Fogarty-like" procedure was performed. However, we failed to achieve good coronary flow because the thrombus was large and hard with a calcified surface revealed by intravascular ultrasound examination. Ultimately, compression of the thrombus with the AngioSculpt™ scoring balloon catheter (AngioScore, Fremont, CA) led to resolution of normal coronary flow without the need for implantation of a coronary stent. Calcified thrombus is rarely observed in a coronary artery embolism, especially one formed in the left atrial appendage. In this case, the AngioSculpt scoring balloon catheter shows efficacy in treating this calcified thrombus.
authors.affiliation: Intensive and Cardiac Care Unit, Nippon Medical School, Tokyo, Japan. y-hosokawa@nms.ac.jp
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Hosokawa
authors.forename: Keiji
authors.initials: K
authors.lastname: Tanaka
authors.forename: Kyoichi
authors.initials: K
authors.lastname: Mizuno
mesh_terms: D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D001281:Atrial Fibrillation / Q000150:complications*; D017023:Coronary Angiography; D003328:Coronary Thrombosis / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D017548:Echocardiography, Transesophageal; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D009203:Myocardial Infarction / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D015607:Stents