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Intracoronary tenecteplase in STEMI with massive thrombus
P B Jayagopal1, Khadhar Mohamed Sarjun Basha2
1Lakshmi Hospital, Palakkad, Kerala, 678013, India.
Insights
Low-dose intracoronary thrombolysis effectively treated ST-elevation myocardial infarction (STEMI) patients with large thrombus burdens. This approach improved coronary blood flow and reduced the need for stenting, with no adverse events observed.
Area of Science:
- Cardiology
- Interventional Cardiology
- Emergency Medicine
Background:
- Primary percutaneous coronary intervention is the standard treatment for ST-elevation myocardial infarction (STEMI).
- A large thrombus burden in STEMI patients undergoing angioplasty predicts stent thrombosis and adverse cardiac events.
Abstract:
Primary percutaneous coronary intervention is the current standard of care in ST elevation myocardial infarction (STEMI). However, large thrombus is an independent predictor for stent thrombosis and major adverse cardiac events in patients undergoing primary angioplasty for STEMI. Here we report a series of STEMI patients with large thrombus burden treated successfully with low dose intracoronary thrombolysis. There was prompt and early ST resolution. There was improvement in thrombolysis in myocardial infarction (TIMI) flow and myocardial blush grade postlysis in all patients. Majority had recanalised infarct related coronary artery thus obviating the need for stenting. There was no inhospital or 1 month mortality or bleeding events. Hence intracoronary thrombolysis is an option in patients with large thrombus burden.
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