title: Intracoronary bivalirudin: a new way to appease the hostile thrombus?
abstract: Intracoronary thrombi are a common finding in the setting of acute coronary syndromes and correlate with intraprocedural complications, adverse prognosis and unpredictable response to standard pharmacological and interventional treatment. Interventional cardiologists have learned to fear the so-called hostile thrombus, with its aggressive and unstable behavior often leading to abrupt and refractory vessel closure. Here we report a case series of intracoronary bivalirudin administration to treat massive intracoronary thrombi, leading to rapid clot disappearance and coronary blood flow restoration. Interventional cardiologists might consider intracoronary bivalirudin administration as a bailout strategy during unusual critical situations.
authors.affiliation: a2nd Division of Cardiology, 'Maggiore della Carità' University Hospital, Novara bInterventional Cardiology Unit, San Donato Hospital, Arezzo cDepartment of Clinical and Experimental Medicine, University of Eastern Piedmont, Novara dDivision of Interventional Cardiology, 'Ospedali Riuniti Marche Nord', Pesaro, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Lupi
authors.forename: Italo
authors.initials: I
authors.lastname: Porto
authors.forename: Andrea
authors.initials: A
authors.lastname: Rognoni
authors.forename: Gioel G
authors.initials: GG
authors.lastname: Secco
authors.forename: Rosario
authors.initials: R
authors.lastname: Parisi
authors.forename: Giulia
authors.initials: G
authors.lastname: Genoni
authors.forename: Maurizio
authors.initials: M
authors.lastname: Lazzero
authors.forename: Angelo S
authors.initials: AS
authors.lastname: Bongo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000379:methods; D000991:Antithrombins / Q000008:administration & dosage*; D017023:Coronary Angiography / Q000379:methods; D005260:Female; D006629:Hirudins / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000008:administration & dosage*; D011994:Recombinant Proteins / Q000008:administration & dosage; D013927:Thrombosis / Q000188:drug therapy*
chemical_list: D000991:Antithrombins; D006629:Hirudins; D010446:Peptide Fragments; D011994:Recombinant Proteins; C074619:bivalirudin