Intracoronary artery retrograde thrombolysis for ST-segment elevation myocardial infarction with a tortuous coronary artery: A case report and review of the literature

Background How to deal with large thrombus burdens of culprit’s blood vessel remains a great challenge in the treatment of acute myocardial infarction. Case presentation A 32-year-old Chinese man was diagnosed with ST-segment elevation myocardial infarction (STEMI). Coronary angiography revealed tha...

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Published inFrontiers in cardiovascular medicine Vol. 9
Main Authors Shen, Mingzhi, Lu, Haihui, Liao, Yichao, Wang, Jian, Guo, Yi, Zhou, Xinger, Nong, Yingqiao, Fu, Zhenhong, Wang, Jihang, Guo, Yuting, Zhao, Shihao, Fan, Li, Tian, Jinwen
Format Journal Article
LanguageEnglish
Published Frontiers Media S.A 04.08.2022
Subjects
Cardiovascular Medicine
intracoronary retrograde thrombolysis
myocardial infarction
reperfusion preconditioning
thrombosis
tortuous coronary artery
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Summary:Background How to deal with large thrombus burdens of culprit’s blood vessel remains a great challenge in the treatment of acute myocardial infarction. Case presentation A 32-year-old Chinese man was diagnosed with ST-segment elevation myocardial infarction (STEMI). Coronary angiography revealed that the distal end of a tortuous left circumflex was completely occluded by a large amount of thrombus. Cutted balloon-directed intracoronary artery retrograde thrombolysis (ICART) with urokinase led to the restoration of coronary blood flow. Because there was no obvious plaque rupture or artery stenosis in the coronary artery, it was only dilated, and no stent was implanted. Conclusion Cutted balloon-directed ICART can be performed effectively and safely in some STEMI patients with tortuous coronary vessels and large thrombus. (REST or named ICART ClinicalTrials.gov number, ChiCTR1900023849).
Bibliography:This article was submitted to Cardiovascular Therapeutics, a section of the journal Frontiers in Cardiovascular Medicine
Reviewed by: Manel Sabate, Hospital Clinic of Barcelona, Spain; Enrico Romagnoli, Agostino Gemelli University Polyclinic (IRCCS), Italy
These authors have contributed equally to this work
Edited by: Jun Yu, Temple University, United States
ISSN:2297-055X
2297-055X
DOI:10.3389/fcvm.2022.934489