Intravascular ultrasound-guided management of large thrombus burden in an aneurysmal coronary artery in a young male.
Management of acute thrombotic occlusion of coronary artery aneurysms is challenging with a lack of randomized trial evidence. We report an unusual case of a 30-year-old Indian Australian male who presented with an extensive anterior STEMI because of very large thrombus burden in a dilated proximal left anterior descending artery. A relatively conservative treatment approach comprising emergency aspiration thrombectomy and ongoing infusion of glycoprotein IIb/IIIa inhibitor, guided by surveillant inpatient angiography and intravascular ultrasound, helped achieve a satisfactory outcome in a complex setting in which percutaneous coronary angioplasty and stenting were not desirable. © 2014 Wiley Periodicals, Inc.
Monash Heart, Monash Medical Centre, Clayton, Victoria, 3168, Australia.
Vimalraj
V
Boganashanmugam
Monash Heart, Monash Medical Centre, Clayton, Victoria, 3168, Australia.
Peter J
PJ
Psaltis
Monash Heart, Monash Medical Centre, Clayton, Victoria, 3168, Australia.
Paul
P
Antonis
D000328:Adult; D003323:Coronary Aneurysm / Q000150:complications* / Q000175:diagnosis; D017023:Coronary Angiography; D003328:Coronary Thrombosis / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D008297:Male; D025321:Surgery, Computer-Assisted / Q000379:methods*; D017131:Thrombectomy / Q000379:methods*; D018084:Ultrasonography, Interventional / Q000379:methods*
IVUS in STEMI; Nonocclusive plaque; very large thrombus burden