Use of intracoronary thrombolysis for huge thrombus burden in an ectatic right coronary artery

Hatim Al-Lawati, Hafidh Alhadi*, Sunil K. Nadar

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Managing a high intracoronary (IC) thrombus burden is a major challenge in patients with ectatic coronary arteries who present with an ST-elevation myocardial infarction (STEMI). We report a 45-year-old male patient who presented to the Department of Medicine, Sultan Qaboos University Hospital, Muscat, Oman, in 2017 with an inferior STEMI. Coronary angiography revealed ectatic coronary arteries with an occluded right coronary artery (RCA). The RCA had a massive thrombus burden that did not resolve with aspiration thrombectomy or balloon angioplasty. Subsequently, IC thrombolysis was administered resulting in significant reperfusion. During the course of his treatment, the patient suffered from intracranial bleeding as a complication; however, he recovered completely with no residual neurological sequelae. This case report demonstrates that IC thrombolysis is a valid option in patients with a massive thrombus burden in the setting of a STEMI, albeit with an increased risk of major bleeding.

Original languageEnglish
Pages (from-to)e390-e393
JournalSultan Qaboos University Medical Journal
Volume20
Issue number4
DOIs
Publication statusPublished - Nov 2020
Externally publishedYes

Keywords

  • Case Report
  • Ectasia
  • Mechanical Thrombolysis
  • Myocardial Infarction
  • Oman

ASJC Scopus subject areas

  • Medicine(all)

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