title: A 2-step optical coherence tomography guided therapeutic approach to acute myocardial infarction secondary to stent thrombosis.
abstract: Myocardial infarction secondary to stent thrombosis has high mortality and recurrence rate. Emergency PCI has high risk of no-reflow. We used a 2-step approach of early recanalization with minimal mechanical intervention followed by delayed PCI 1-2days later guided by Optical Coherence Tomography (OCT). From October 2011 to December 2013, we treated 5 patients with this approach. Time from early recanalization to the delayed definitive PCI was 1day (median, range 1-3days). All the OCT images were diagnostic with a clear view of the underlying structures.
  
  
  CONCLUSIONS
  A 2-step approach to treat stent thrombosis appears beneficial with low incidence of peri-procedural thrombosis or no-reflow phenomena during the second step, and superb OCT imaging.
authors.affiliation: Vancouver General Hospital, Division of Cardiology University of British Columbia, Vancouver, BC; Stavanger University Hospital, Department of Cardiology, Stavanger, Norway. Electronic address: nigussie.bogale@lyse.net.
authors.forename: Nigussie
authors.initials: N
authors.lastname: Bogale
authors.affiliation: Vancouver General Hospital, Division of Cardiology University of British Columbia, Vancouver, BC.
authors.forename: Mathieu
authors.initials: M
authors.lastname: Lempereur
authors.affiliation: Vancouver General Hospital, Division of Cardiology University of British Columbia, Vancouver, BC.
authors.forename: Anthony Y
authors.initials: AY
authors.lastname: Fung
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017023:Coronary Angiography; D003328:Coronary Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000295:instrumentation*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011237:Predictive Value of Tests; D019233:Retreatment; D015607:Stents; D017131:Thrombectomy; D013997:Time Factors; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome
chemical_list: D010975:Platelet Aggregation Inhibitors
keywords: Acute myocardial infarction; Optical coherence tomography; Stent thrombosis