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Lone aspiration thrombectomy without stenting for a patient with ST-segment elevation myocardial infarction

Tetsuro Yokokawa1, Yuichi Ujiie, Hironori Kaneko

  • 1Department of Cardiology, Hoshi General Hospital, 159-1 Mukaibaramachi, Koriyama, 963-8501, Japan, yokotetu@fmu.ac.jp.

Cardiovascular Intervention and Therapeutics
|December 17, 2013
PubMed

Insights

A 57-year-old male with ST-segment elevation myocardial infarction (STEMI) underwent successful aspiration thrombectomy for a right coronary artery thrombus. Intracoronary ultrasound revealed coronary ectasia, and further interventions were deferred.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Vascular Imaging

Background:

  • ST-segment elevation myocardial infarction (STEMI) is a critical condition requiring prompt reperfusion.
  • Coronary artery thrombus formation can lead to STEMI, necessitating intervention.
  • Coronary ectasia, a dilation of the coronary artery, can present unique challenges during interventions.

Observation:

  • A 57-year-old male with a history of myocardial infarction presented with STEMI.
  • Coronary angiography identified a thrombus with delayed flow in the distal right coronary artery.
  • Intracoronary ultrasound imaging revealed the presence of coronary ectasia.

Findings:

  • Successful aspiration thrombectomy restored TIMI 3 flow, indicating successful reperfusion.
  • The patient's STEMI was associated with coronary ectasia.
  • Stenting and balloon angioplasty were deferred following the thrombectomy.

Implications:

  • Aspiration thrombectomy can be a successful standalone treatment for STEMI in the presence of coronary ectasia.
  • Deferred stenting in STEMI with coronary ectasia may be a viable strategy, warranting further investigation.
  • This case highlights the importance of intracoronary imaging in guiding STEMI management, especially with unusual vascular findings.

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