Abstract
We report a novel complication that arose while treating a 54 year old man with acute inferior ST elevation segment myocardial infarction. It was decided to perform thrombus aspiration prior to balloon angioplasty. However, after aggressive maneuvers to cross the tight lesion in order to suck the distal thrombus, a novel complication was encountered. The Thrombus Aspiration Catheter (TAC) got stuck in the coronary artery. When the whole apparatus was pulled out, it was realized that the guidewire cut the main shaft of TAC and catheter got twisted over the wire. To the best of our knowledge, this is the first report of a complication of this type.
Highlights
Due to the inherent advantages of thrombus aspiration in the treatment of ST Elevation Segment Myocardial Infarction (STEMI), there is a growing body of interest on thrombus aspiration devices [1-3]
Thrombus aspiration has become an important tool for the removal of thrombi that lead to STEMI
Several studies like TAPAS and EXPIRA have confirmed that aspiration thrombectomy may improve Thrombolysis In Myocardial Infarction (TIMI) flow, myocardial blush scores, and ST-Segment Resolution (STR) and less myocardial longitudinal deformation [1-3]
Summary
Due to the inherent advantages of thrombus aspiration in the treatment of ST Elevation Segment Myocardial Infarction (STEMI), there is a growing body of interest on thrombus aspiration devices [1-3]. The initial electrocardiogram showed 3 mm of ST segment elevation in the inferior leads and 2 mm of ST segment depression in the anterior leads consistent with an acute inferior wall STEMI He was treated with 5000 units of heparin intravenously, 300 mg of aspirin and clopidogrel (600 mg loading dose) at the emergency department. It was decided to perform distal suction as well, but after a few unsuccessful attempts to cross the proximal lesion, balloon angioplasty was performed with a 3.0×25 mm Maverick balloon (Boston Scientific) at a pressure of 8 atm at the proximal lesion Another attempt was made to cross the lesion again with the thrombus aspiration catheter and it was difficult to cross the lesion due to the kink but managed to cross when pushed hard. The main shaft of the TAC was found ruptured from the guidewire starting from its back till its suction tip and the whole wire was twisted over the main shaft of TAC (Figure 3)
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