TY - JOUR
T1 - Use of intracoronary thrombolysis for huge thrombus burden in an ectatic right coronary artery
AU - Al-Lawati, Hatim
AU - Alhadi, Hafidh
AU - Nadar, Sunil K.
N1 - Publisher Copyright:
© 2020, Sultan Qaboos University. All rights reserved.
PY - 2020/11
Y1 - 2020/11
N2 - 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.
AB - 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.
KW - Case Report
KW - Ectasia
KW - Mechanical Thrombolysis
KW - Myocardial Infarction
KW - Oman
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U2 - 10.18295/squmj.2020.20.04.018
DO - 10.18295/squmj.2020.20.04.018
M3 - Article
C2 - 33414947
AN - SCOPUS:85100228694
SN - 2075-051X
VL - 20
SP - e390-e393
JO - Sultan Qaboos University Medical Journal
JF - Sultan Qaboos University Medical Journal
IS - 4
ER -