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Thrombolytic therapy of a stenosed coronary vein bypass graft with continuous intragraft streptokinase drip

M Mosseri1, Y Hasin, D Admon

  • 1Cardiac Department, Hadassah University Hospital, Jerusalem, Israel.

Cardiology
|January 1, 1990
PubMed

Insights

A patient with coronary artery disease experienced angina due to a blocked saphenous vein graft. Continuous infusion of streptokinase (STK) successfully dissolved the graft thrombus, relieving symptoms and demonstrating STK

Area of Science:

  • Cardiology
  • Vascular Surgery

Background:

  • Saphenous vein grafts (SVGs) are commonly used for coronary artery bypass grafting.
  • Graft thrombosis is a significant cause of graft failure and myocardial infarction.
  • Thrombolytic therapy is a potential treatment for SVG occlusion.

Observation:

  • A patient presented with new-onset angina due to acute thrombotic occlusion of an SVG to the left anterior descending coronary artery.
  • The patient underwent direct intragraft infusion of streptokinase (STK).

Findings:

  • Successful treatment was achieved with a direct intragraft infusion of streptokinase (STK).
  • A continuous intragraft infusion of 1.5 million units of STK over 20 hours led to complete dissolution of the graft thrombus.
  • The patient experienced remarkable relief of angina and was discharged on oral anticoagulants.

Implications:

  • Continuous intragraft infusion of STK is an effective treatment for recently formed thrombi in saphenous vein grafts.
  • This approach offers a potential alternative to surgical intervention for SVG thrombosis.
  • Further research may explore the long-term efficacy and safety of this treatment modality.

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