A Rare Complication of Primary Percutaneous Coronary Intervention: Total Occlusion of The Adjacent Coronary Artery To Culprit Lesion
Abstract
Recently, distal embolization of thrombus and plaque debris, as assessed by angiography, has been identified as one of the major drawback of primary PCI in the setting of ST elevation myocardial infarction STEMI , limiting myocardial reperfusion and leading to larger myocardial damage and worse prognosis. However, proximal embolization can occur as a rare event in patients undergoing primary PCI. In this manuscript, we presented two total occlusion cases which occured due to proximal embolization of successful primary PCI
References
- Grines CL, Browne KF, Marco J, Rothbaum D, Stone GW, O’Keefe, et al. A comparison of primary angioplasty with thrombolytic therapy for acute myocardial infarction. N Engl J Med. 1993; 328:673-79.
- Weaver WD, Simes RJ, Betriu A, Grines CL, Zijlstra F, Garcia E, et al. Comparison of primary coronary angioplasty and intravenous thrombolitic therapy for acute myocardial infarction. A meta analysis. JAMA 1997; 278:2093-98.
- Levine GN, Kern MJ, Berger PB, Brown DL, Klein LW, Kereiakes DJ, et al. American Heart Association Diagnostic and Interventional Catheterization Commitee and Council on Clinical Cardiology. Management of patients undergoing percutaneous coronary revascularization. Ann Intern Med. 2003;139:123-36.
- Ito H, Okamura A, Iwakura K, Masuyama T, Hori M, Takiuchi S, et al. Myocardial perfusion patterns related to thrombolysis in myocardial infarction perfusion grades after coronary angioplasty in patients with acute anterior myocardial infarction. Circulation 1996 ; 93:1993-99.
- Henriques JPS, Zijlstra F, Ottervanger JP, de Boer M-J, van’t Hof AWJ, Hoorntje JCA, et al. Incidence and clinical significance of distal embolization during primary angioplasty for acute myocardial infarction. Eur Heart J. 2002 ; 23:1112-17.
- Kawamura A, Tilem M, Gossman DE. Rheolytic thrombectomy for thromboembolic occlusion of the internal carotid artery complicating coronary intervention. J Invasive Cardiol. 2006; 18:108-10.
- Sardella G, Mancone M, Ducci CB, Agati L, Scardala R, Carbone I, et al. Thrombus aspiration during primary percutaneous coronary intervention improves myocardial reperfusion and reduces infarct size. J Am Coll Cardiol. 2009;53:309-15.
- Svilaas T, Vlaar JP, Vander horst CI, Diercks GFH, De Smet BJGL, Van dn Heuvel AdFm, et al. Thrombus aspiration during primary percutaneous coronary intervention. N Engl J Med. 2008; 358:557-67.
Primer Perkütan Koroner Girişimin Nadir Bir Komplikasyonu: Sorumlu Lezyona Komşu Koroner Arterde Gelişen Total Oklüzyon
Abstract
ST yükselmeli miyokard infarktüsü STYMİ olan hastalarda, primer perkutan koroner girişim PKG sırasında gelişen trombotik ve aterosklerotik materyal embolizasyonu bu işlem içim önemli bir dezavantajdır. Çünkü distal embolizasyon bu hastalarda başarılı reperfüzyonu engelleyerek, daha fazla miyokardiyal hasara ve daha kötü prognoza yol açar. Bununla birlikte, primer PKG uygulanan hastalarda nadir olarak proksimal embolizasyon da gelişebilmektedir. Biz bu yazıda, başarılı primer PKG uygulanan iki hastada, proksimal embolizasyona bağlı gelişen total oklüzyon olgularını sunduk
References
- Grines CL, Browne KF, Marco J, Rothbaum D, Stone GW, O’Keefe, et al. A comparison of primary angioplasty with thrombolytic therapy for acute myocardial infarction. N Engl J Med. 1993; 328:673-79.
- Weaver WD, Simes RJ, Betriu A, Grines CL, Zijlstra F, Garcia E, et al. Comparison of primary coronary angioplasty and intravenous thrombolitic therapy for acute myocardial infarction. A meta analysis. JAMA 1997; 278:2093-98.
- Levine GN, Kern MJ, Berger PB, Brown DL, Klein LW, Kereiakes DJ, et al. American Heart Association Diagnostic and Interventional Catheterization Commitee and Council on Clinical Cardiology. Management of patients undergoing percutaneous coronary revascularization. Ann Intern Med. 2003;139:123-36.
- Ito H, Okamura A, Iwakura K, Masuyama T, Hori M, Takiuchi S, et al. Myocardial perfusion patterns related to thrombolysis in myocardial infarction perfusion grades after coronary angioplasty in patients with acute anterior myocardial infarction. Circulation 1996 ; 93:1993-99.
- Henriques JPS, Zijlstra F, Ottervanger JP, de Boer M-J, van’t Hof AWJ, Hoorntje JCA, et al. Incidence and clinical significance of distal embolization during primary angioplasty for acute myocardial infarction. Eur Heart J. 2002 ; 23:1112-17.
- Kawamura A, Tilem M, Gossman DE. Rheolytic thrombectomy for thromboembolic occlusion of the internal carotid artery complicating coronary intervention. J Invasive Cardiol. 2006; 18:108-10.
- Sardella G, Mancone M, Ducci CB, Agati L, Scardala R, Carbone I, et al. Thrombus aspiration during primary percutaneous coronary intervention improves myocardial reperfusion and reduces infarct size. J Am Coll Cardiol. 2009;53:309-15.
- Svilaas T, Vlaar JP, Vander horst CI, Diercks GFH, De Smet BJGL, Van dn Heuvel AdFm, et al. Thrombus aspiration during primary percutaneous coronary intervention. N Engl J Med. 2008; 358:557-67.
Details
| Primary Language | Turkish |
|---|---|
| Journal Section | Case Report |
| Authors | |
| Publication Date | June 1, 2010 |
| Published in Issue | Year 2010Issue: 2 |