Abstract
Stent thrombosis is an example of device-induced, platelet-mediated arterial thrombosis with a potentially fatal adverse event that often leads to myocardial infarction and/or death. The optimal treatment of patients with drug-eluting stent thrombosis in whom mechanical thrombectomy has failed is not established. This case demonstrates the usefulness of intracoronary thrombolysis after failed mechanical thrombectomy in patients with stent thrombosis. To our knowledge, this is the first report on using intracoronary thrombolysis in this specific situation.
Zusammenfassung
Eine Stentthrombose ist ein Beispiel für eine instrumenteninduzierte, plättchenvermittelte arterielle Thrombose mit einem potenziell letalen unerwünschten Ereignis, das oft zu einem Herzinfarkt und/oder Tod führt. Es gibt keine etablierte optimale Behandlung von Patienten mit Thrombose eines medikamentenfreisetzenden Stents, bei denen die mechanische Thrombektomie nicht gelingt. Der vorliegende Fall zeigt den Nutzen der intrakoronaren Thrombolyse nach misslungener mechanischer Thrombektomie bei Patienten mit Stentthrombose. Soweit den Autoren bekannt ist, ist dies die erste Beschreibung der Verwendung einer intrakoronaren Thrombolyse in dieser speziellen Situation.
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Additional material onlineThis article includes two additional Videos. You will find this supplemental at dx.doi.org/10.1007/s00059-013-3876-1.
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Video 2: Repeated coronary angiography revealed that the large thrombus completely dissolved with TIMI 3 distal flow (MPG 0,8MB)
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Karabay, C., Kocabay, G., Kalayci, A. et al. “Rescue administration” of intracoronary thrombolytic therapy for drug-eluting stent thrombosis. Herz 39, 647–650 (2014). https://doi.org/10.1007/s00059-013-3876-1
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DOI: https://doi.org/10.1007/s00059-013-3876-1