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Thrombolysis-facilitated primary percutaneous coronary intervention as a therapeutic approach to stent thrombosis

Simcha R Meisel1, Michael Shochat1, Aaron Frimerman1

  • 1Heart Institute, Hillel Yaffe Medical Center, Hadera, affiliated to the Rappaport Medical School, The Technion- Israel Institute of Technology, Haifa, Israel.

Cardiovascular Revascularization Medicine : Including Molecular Interventions
|May 19, 2015
PubMed

Insights

Thrombolysis-facilitated percutaneous coronary intervention (PCI) improved coronary artery patency in patients with stent thrombosis. This approach may be a viable treatment option for stent thrombosis, though it did not improve cardiac function in this study.

Area of Science:

  • Cardiology
  • Interventional Cardiology

Background:

  • Stent thrombosis is a serious complication after percutaneous coronary intervention (PCI).
  • Current treatment involves immediate PCI to restore blood flow.

Purpose of the Study:

  • To evaluate the efficacy of thrombolysis followed by immediate PCI in treating stent thrombosis.
  • To compare coronary patency and flow in patients treated with thrombolysis-facilitated PCI versus primary PCI.

Main Methods:

  • Six patients with ST-elevation myocardial infarction (STEMI) due to stent thrombosis received thrombolysis followed by immediate PCI.
  • Coronary patency, TIMI flow, and TIMI myocardial perfusion grade (TMPG) were assessed.
  • Results were compared to a control group treated with primary PCI.

Main Results:

  • Thrombolysis-facilitated PCI group showed significantly improved coronary patency (5/6 arteries) compared to the control group (0/9 arteries).
  • Pre-intervention TIMI flow and TMPG were significantly higher in the treatment group (p<0.001).
  • Improved coronary flow did not translate to better cardiac function in the treatment group.

Conclusions:

  • Thrombolysis-facilitated PCI may be beneficial for treating stent thrombosis.
  • This approach should be considered a viable therapeutic option and not contraindicated.
  • Further evaluation is warranted to confirm its clinical benefits.
Abstract

Keywords:
Primary percutaneous coronary interventionST-elevation myocardial infarctionStent thrombosisThrombolysis

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