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Rheolytic therapy combined with intragraft abciximab for treatment in acute myocardial infarction

Ajay Vallakati1, Lou Mastrine, Sergey Ayzenberg

  • 1Department of Internal Medicine, Maimonides Medical Center, 4802 Tenth Avenue, Brooklyn, NY 11219, USA.

The Journal of Invasive Cardiology
|February 8, 2013
PubMed

Insights

For acute coronary syndrome after bypass surgery, rheolytic thrombectomy effectively cleared high clot burden in a saphenous vein graft. This restored blood flow, treating ST-elevation myocardial infarction.

Area of Science:

  • Interventional Cardiology
  • Vascular Surgery

Background:

  • Coronary artery bypass graft (CABG) surgery can lead to challenging graft lesions.
  • Acute coronary syndrome (ACS) in post-CABG patients often involves high clot burden in saphenous vein grafts.

Observation:

  • A patient presented with ST-segment elevation myocardial infarction due to a significant clot burden in a bypass graft.
  • The patient had a history of coronary artery bypass graft surgery.

Findings:

  • Rheolytic thrombectomy was performed to address the high clot burden.
  • Localized administration of glycoprotein IIb/IIIa inhibitors was utilized.
  • Successful restoration of Thrombolysis in Myocardial Infarction (TIMI) grade 3 flow was achieved.

Implications:

  • Rheolytic thrombectomy is a viable option for managing acute graft occlusions with high clot burden.
  • Combined with local glycoprotein IIb/IIIa inhibition, it offers an effective treatment strategy for post-CABG ACS.
  • This approach can successfully restore coronary blood flow in critical situations.

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