Abstract
We are reporting the case of a 64-year-old woman with acute inferior ST elevation myocardial infarction with right ventricular infarction. She underwent primary angiography which revealed total occlusion of distal right coronary artery (RCA) by thrombus. Three runs of aspiration were performed and the thrombus was aspirated from RCA without additional ballooning or stenting. Postaspiration angiography revealed normal TIMI-3 flow down with the resolution of the thrombus and a residual noncritical trombus was seen also. She was started on glycoprotein (GP) IIb-IIIa inhibitor tirofiban for 48 h. A new angiography performed on the 4th post-intervention day and TIMI-3 flow down was seen in RCA with complete disappearance of the residual thrombus. Key words: Intracoronary thrombus, acute myocardial infarction, thrombus aspiration.
Highlights
ST-segment elevation myocardial infarction (STEMI) results from occlusive thrombus formation at the site of plaque rupture or erosion (DeWood et al, 1980; Falk, 1983)
The current management of STEMI consists of primary angioplasty, including thrombus aspiration and stenting (Yang et al, 2005; Svilaas et al, 2008)
We describe and discuss a case of acute inferior ST elevation myocardial infarction with right ventricular infarction in which there is successful initial use of an aspiration catheter without additional balooning or stenting and effectiveness of tirofiban (Aggrastat, Merck Sharp and Dohme, USA) treatment for
Summary
Can mechanical thrombectomy replace angioplasty for the treatment of patients with ST-segment elevation myocardial infarction (STEMI)? Report of a case. We are reporting the case of a 64-year-old woman with acute inferior ST elevation myocardial infarction with right ventricular infarction. She underwent primary angiography which revealed total occlusion of distal right coronary artery (RCA) by thrombus. Postaspiration angiography revealed normal TIMI-3 flow down with the resolution of the thrombus and a residual noncritical trombus was seen . She was started on glycoprotein (GP) IIb-IIIa inhibitor tirofiban for 48 h. A new angiography performed on the 4th post-intervention day and TIMI-3 flow down was seen in RCA with complete disappearance of the residual thrombus
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