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Occlusion of the Great and Small Saphenous Vein Using Copolymeric Glue Based on N-Butyl Cyanoacrylate and Methacryloxy Sulfolane
Published on: December 9, 2022
Successful treatment of saphenous venous graft thrombus by tirofiban infusion
Tunay Sentürk1, Aysel Aydin Kaderli, Ozlem Aydin
1Department of Cardiology, School of Medicine, Uludag University, Görükle, Bursa, Turkey. tunaysenturk@hotmail.com
Insights
Glycoprotein IIb/IIIa inhibitors effectively dissolved a large thrombus in a saphenous vein graft, restoring blood flow. This suggests their potential utility in managing acute coronary syndrome involving such grafts.
Area of Science:
- Cardiology
- Vascular Medicine
- Interventional Cardiology
Background:
- Saphenous vein grafts (SVGs) are prone to thrombosis, a significant cause of acute coronary syndrome (ACS).
- Intraluminal thrombus in SVGs poses a challenge for reperfusion therapies.
Observation:
- A 60-year-old male patient with prior coronary-artery bypass grafting presented with ACS symptoms.
- Coronary angiography identified a large intraluminal thrombus within an SVG supplying the obtuse marginal artery.
Findings:
- Intravenous administration of tirofiban, a glycoprotein IIb/IIIa inhibitor, was initiated.
- Repeat angiography demonstrated complete thrombus dissolution and Thrombolysis In Myocardial Infarction (TIMI) grade 3 flow within 48 hours.
Implications:
- Glycoprotein IIb/IIIa inhibitors show promise as an effective treatment for thrombus-laden SVGs in ACS.
- This case highlights a potential therapeutic strategy to improve outcomes in patients with SVG thrombosis.
Abstract:
A 60-year old man with a history of coronary-artery bypass grafting presented with symptoms of acute coronary syndrome. Coronary angiography revealed a huge intraluminal thrombus in the saphenous vein graft to the second obtuse marginal branch of the left circumflex artery. A glycoprotein IIb/IIIa inhibitor (tirofiban) was administered intravenously. Two days later, thrombus dissolution and Thrombolysis In Myocardial Infarction (TIMI) grade 3 flow were evident on repeat coronary angiography. Glycoprotein IIb/IIIa inhibitors may be useful in a thrombus-laden saphenous-vein graft.
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