When the Going Gets Tough: Stepping-Up With the Penumbra System for Aneurismatic Right Coronary Artery
Gabriele Venturi1, Alberto Zamboni1, Francesco Bacchion1
1Mater Salutis Hospital, Legnago, Italy.
Insights
Percutaneous intervention for coronary aneurysms is challenging due to thrombus. A mechanical thrombectomy system successfully treated a patient after manual aspiration failed, achieving long-term success.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Vascular Surgery
Background:
- Coronary aneurysms pose significant challenges during percutaneous interventions.
- Large thrombus burden increases the risk of the no-reflow phenomenon, complicating procedures.
Observation:
- Manual thrombus aspiration was initially attempted but proved insufficient.
- A step-up approach utilizing a mechanical thrombectomy system was then employed.
Findings:
- The mechanical thrombectomy system achieved immediate and successful removal of coronary thrombus.
- The intervention resulted in both short-term and long-term angiographic success.
Implications:
- Mechanical thrombectomy offers a viable solution for complex coronary aneurysms with significant thrombus.
- This approach can mitigate the risk of the no-reflow phenomenon, improving procedural outcomes.
Abstract:
Coronary aneurysms represent a challenge in terms of percutaneous interventions, due to the possible large amount of coronary thrombus and the subsequent risk of no-reflow phenomenon. In this case, a step-up approach from a failed manual thrombus aspiration to a mechanical system led to immediate and long-term angiographic success.
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