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Case Report
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Korean J Med. 2014;87(6):728-732. Published online December 1, 2014.
DOI: https://doi.org/10.3904/kjm.2014.87.6.728
- 적혈구 증가증에서 거대 심혈관 혈전의 심혈관내 혈전 용해 및 혈관 성형술
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이혜영, 김병옥, 변영섭, 고충원, 김정훈
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인제대학교 의과대학 상계백병원 심장내과
- Intracoronary Thrombolysis and Delayed Percutaneous Coronary Intervention for the Treatment of Large Coronary Thrombi in a Patient with Polycythemia Vera
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Hye Young Lee, Byung Ok Kim, Young Sup Byun, Choong Won Goh, Jeong Hoon Kim
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Division of Cardiology, Department of Internal Medicine, Sanggye Paik Hospital, Inje University, Seoul, Korea
- Corresponding author: Jeong Hoon Kim ,Tel: +82-2-950-1212, Fax: +82-2-950-1248, Email: jhkimmd@paik.ac.kr
- Received: December 2, 2013; Revised: March 13, 2014 Accepted: March 28, 2014.
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- Abstract
- The benefit of thrombus aspiration during percutaneous coronary intervention in patients with acute myocardial infarction (AMI) is well established; however, the optimal management strategy for patients with a large thrombus burden after repeated thrombectomy (i.e., “failed” thrombectomy) is unknown. Here, we report the case of a 67-year-old male with polycythemia vera who was treated with intracoronary thrombolytic therapy in combination with mechanical thrombectomy. Repeated aspiration thrombectomy did little to reduce the coronary thrombus burden; thus, intracoronary urokinase infusions were applied to the thrombus-containing lesion. Repeat coronary angiography 4 days later revealed markedly improved antegrade flow in the infarct-related artery, and successful revascularization was performed. This case demonstrates the potential utility of intracoronary thrombolytic therapy for select AMI patients with a large thrombus burden who are in a hypercoagulable state.
Keywords :Thrombolytic therapy, Myocardial infarction, Percutaneous coronary intervention
