title: [A multi-device approach to an unusual case of left main thrombosis: when manual thrombectomy is not enough].
abstract: We report an unusual case of left main thrombosis with distal embolization in the left anterior descending coronary artery (LAD). Two filter wires were placed in both LAD and circumflex coronary arteries at the beginning of the procedure. Manual thrombectomy was performed but only a portion of the left main thrombosis was removed; residual debris was displaced into the distal LAD but captured by the filter. A loco-regional infusion of abciximab was finally administered by a microporous balloon in order to treat residual embolization in the distal LAD. This case shows that manual thrombectomy does not always allow for complete and safe removal of thrombotic material, especially when high-burden coronary thrombosis occurs in large, proximal vessels. A multi-device approach has proved useful in this patient, allowing to obtain complete resolution of luminal thrombosis.
authors.forename: Andrea
authors.initials: A
authors.lastname: Picchi
authors.forename: Paolo
authors.initials: P
authors.lastname: Calabria
authors.forename: Andrea
authors.initials: A
authors.lastname: Micheli
authors.forename: Ugo
authors.initials: U
authors.lastname: Limbruno
mesh_terms: D000077284:Abciximab; D054058:Acute Coronary Syndrome / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000627:therapeutic use*; D000925:Anticoagulants / Q000627:therapeutic use; D000069059:Atorvastatin; D003131:Combined Modality Therapy; D017023:Coronary Angiography; D003328:Coronary Thrombosis / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D003331:Coronary Vessels; D057505:Embolic Protection Devices; D004617:Embolism / Q000209:etiology / Q000517:prevention & control; D006538:Heptanoic Acids / Q000627:therapeutic use; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D006937:Hypercholesterolemia / Q000150:complications / Q000188:drug therapy; D007140:Immunoglobulin Fab Fragments / Q000008:administration & dosage / Q000627:therapeutic use*; D007261:Infusions, Intra-Arterial; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D011758:Pyrroles / Q000627:therapeutic use; D013396:Suction; D017131:Thrombectomy / Q000379:methods*; D041623:Tomography, Optical Coherence
chemical_list: D000911:Antibodies, Monoclonal; D000925:Anticoagulants; D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D007140:Immunoglobulin Fab Fragments; D010975:Platelet Aggregation Inhibitors; D011758:Pyrroles; D000069059:Atorvastatin; D000077284:Abciximab