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Direct Re-implantation of Left Coronary Artery into the Aorta in Adults with Anomalous Origin of Left Coronary Artery from the Pulmonary Artery ALCAPA
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Subacute right coronary artery thrombosis treated by using Excimer Laser Coronary Angioplasty: a case report

Daniel Faria1,2, Adrián Jeronimo1, Javier Escaned1

  • 1Hospital Clínico San Carlos, IDISSC, Universidad Complutense de Madrid, Calle del Prof Martín Lagos, 28040 Madrid, Spain.

European Heart Journal. Case Reports
|October 23, 2023
PubMed

Insights

Managing high thrombotic burden during myocardial infarction is difficult. Excimer laser coronary angioplasty successfully vaporized persistent thrombus in a patient with subacute inferior myocardial infarction, improving outcomes.

Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Medical Technology

Background:

  • High thrombotic burden in myocardial infarction presents significant clinical challenges.
  • Optimal management strategies for persistent coronary thrombus require ongoing investigation.

Observation:

  • A 51-year-old male presented with subacute inferior myocardial infarction and persistent chest pain.
  • Coronary angiography revealed severe thrombotic occlusion of the right coronary artery.
  • Initial balloon angioplasty failed to restore adequate distal blood flow (TIMI II).

Findings:

  • Excimer Laser Coronary Angioplasty (ELCA) was employed to address the residual thrombus.
  • The laser angioplasty procedure resulted in successful thrombus vaporization.
  • Improved distal coronary blood flow was achieved post-ELCA.

Implications:

  • This case highlights the potential of niche technologies like ELCA in managing complex coronary thrombus.
  • Revisiting percutaneous and non-percutaneous strategies is crucial for optimizing treatment of persistent coronary thrombus.
  • Laser angioplasty offers a viable option for refractory thrombotic occlusions in myocardial infarction.
Abstract

Keywords:
Acute coronary syndromeCase reportCoronary artery diseaseELCAIVUSLaser therapyMyocardial infarction

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