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.

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