Aspiration thrombectomy and intracoronary tirofiban via GuideLiner®catheter for a thrombosed aneurysmal vessel.
A 52-year-old Asian male with no traditional risk factors for coronary artery disease presented with acute coronary syndrome. Coronary angiography showed complete thrombotic occlusion of the left circumflex with a large thrombus burden in the setting of diffuse aneurysmal enlargement of the coronary arteries consistent with antecedent Kawasaki disease. Manual thrombectomy with adjunctive intracoronary tirofiban was performed utilizing the GuideLiner catheter®(Vascular Solutions, Inc., MN, USA). Stent implantation was deferred. Follow-up imaging 48 h later showed preserved coronary flow and decreased thrombus burden. The GuideLiner catheter, a monorail guiding device, served a novel role in thrombus aspiration and intracoronary medication delivery.
Department of Medicine, University of California, Irvine, 101 The City Drive, Suite #400, Orange, CA 92868, USA.
James
J
Fry
Department of Medicine, University of California, Irvine, 101 The City Drive, Suite #400, Orange, CA 92868, USA.
Ali
A
Naqvi
Department of Medicine, University of California, Irvine, 101 The City Drive, Suite #400, Orange, CA 92868, USA.
Amit
A
Bahia
Department of Medicine, University of California, Irvine, 101 The City Drive, Suite #400, Orange, CA 92868, USA.
Arnold
A
Seto
D006328:Cardiac Catheterization / Q000379:methods; D017024:Chemotherapy, Adjuvant / Q000379:methods; D017023:Coronary Angiography; D003328:Coronary Thrombosis / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000601:surgery*; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D061185:Mechanical Thrombolysis / Q000379:methods*; D008875:Middle Aged; D000077466:Tirofiban; D016896:Treatment Outcome; D014443:Tyrosine / Q000031:analogs & derivatives* / Q000627:therapeutic use
D005343:Fibrinolytic Agents; D014443:Tyrosine; D000077466:Tirofiban
GuideLiner®; Kawasaki disease; antiplatelet agents; coronary aneurysm; deferred stenting; direct factor Xa inhibitor; ectasia; interventional; intra-coronary tirofiban; thrombus aspiration