Challenges in Primary PCI: How to Treat a Large Intracoronary Thrombus With TIMI 3 Flow?

This case highlights 2 important issues: the immediate management of large intracoronary thrombus in the ST-segment elevation myocardial infarction setting with TIMI 3 flow, and the risks/benefits associated with sealing a plaque in an unobstructed artery by stenting. Potent antithrombotic therapy w...

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Bibliographic Details
Published in:The Journal of invasive cardiology 2022-02, Vol.34 (2), p.E154
Main Authors: Theodoropoulos, Konstantinos C, Felekos, Ioannis, Hung, John D, Khand, Aleem, Stables, Rod H
Format: Article
Language:English
Subjects:
Coronary Angiography - methods
Coronary Thrombosis - diagnosis
Coronary Thrombosis - surgery
Humans
Percutaneous Coronary Intervention - methods
Plaque, Atherosclerotic
ST Elevation Myocardial Infarction - diagnosis
ST Elevation Myocardial Infarction - surgery
Treatment Outcome
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Summary:This case highlights 2 important issues: the immediate management of large intracoronary thrombus in the ST-segment elevation myocardial infarction setting with TIMI 3 flow, and the risks/benefits associated with sealing a plaque in an unobstructed artery by stenting. Potent antithrombotic therapy with a view to subsequent intracoronary imaging to define etiology and plaque morphology appears to be a reasonable initial strategy in this specific population. Furthermore, for patients with acute coronary syndromes diagnosed with plaque erosion by optical coherence tomography and residual diameter stenosis
ISSN:1557-2501
1557-2501
DOI:10.25270/jic/21.00346