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Recurrent Thrombosis in a Case of Coronary Ectasia with Large Thrombus Burden Successfully Treated by Adjunctive

Hung-Hao Lee1, Tsung-Hsien Lin2, Ho-Ming Su2

  • 1Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital;

Acta Cardiologica Sinica
|April 29, 2016
PubMed

Insights

Coronary ectasia with large thrombus burden can resist standard acute myocardial infarction treatments. Long-term warfarin combined with antiplatelet therapy may restore blood flow when other methods fail.

Area of Science:

  • Cardiology
  • Interventional Cardiology

Background:

  • Coronary ectasia (CE) is an uncommon condition often associated with coronary artery stenosis.
  • Acute myocardial infarction (AMI) in CE patients presents unique challenges due to potential large thrombus burden.
  • Standard AMI treatments may be insufficient for CE patients with significant thrombotic load.

Observation:

  • A patient with CE experienced two episodes of AMI within two weeks.
  • Initial percutaneous coronary intervention with aspiration thrombectomy failed to restore adequate blood flow.
  • Pharmacological management with heparin, antiplatelets, and glycoprotein IIb/IIIa inhibitors yielded poor results.

Findings:

  • The patient was subsequently treated with dual antiplatelet therapy plus warfarin.
  • Follow-up angiography demonstrated restored TIMI 3 flow, indicating successful blood flow restoration.
  • This suggests a potential benefit of long-term anticoagulation in specific CE cases.

Implications:

  • For CE patients with large thrombus burden unresponsive to standard AMI treatment, long-term warfarin combined with antiplatelet therapy is a viable alternative.
  • This therapeutic approach may effectively reduce thrombus burden and improve coronary blood flow.
  • Further research is warranted to validate this treatment strategy for coronary ectasia.
Abstract

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