Acute incomplete thrombotic occlusion of distal left main coronary artery treated by tissue plasminogen activator

Aydın, Mehmet; Özeren, Ali; Bilge, Müge

doi:10.1136/hrt.2003.021410

Cited by 4 publications

(9 citation statements)

References 5 publications

(6 reference statements)

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“…Besides, waiting 25 minutes before achievement of normal flow may not be realistic for most patients. Tissue plasminogen activator (tPA) and streptokinase have been used effectively in individual cases [46,47]. Prolonged abciximab infusion with aspirin and heparin in one case and aspirin and ticlopidine in another case was associated with angiographic LMCA thrombus resolution [21,22].…”

Section: Anticoagulation/antiplatelet Therapymentioning

confidence: 98%

“…Intravenous or intracoronary thrombolysis or glycoprotein IIb/IIIa inhibitors have been reported to be effective in individual cases [12,21,22,41,[44][45][46][47]. Pulse spray thrombolysis, a method that uses the synergistic mechanical maceration of thrombi and spray of thrombolytic solution into the thrombus has been utilized in one patient with alteplase 24 million units/100 ml of saline (starting dose of 0.7 ml bolus, 5 times per minute, 3 ml/sec compulsive force).…”

Section: Anticoagulation/antiplatelet Therapymentioning

confidence: 99%

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Left Main Coronary Artery Thrombus: A Case Series with Different Outcomes

Gupta

Rahman

Uretsky

et al. 2005

J Thromb Thrombolysis

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Left main coronary artery (LMCA) thrombosis with acute myocardial infarction is an uncommon condition with an extremely high mortality. The small number of reported cases prevents the development of an evidence-based approach. Hence there are no clear-cut guidelines describing the best management approach for this condition. We describe our experience with six patients who presented with LMCA thrombosis and discuss the epidemiology, etiology and management options available for this high-risk subgroup.

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Section: Anticoagulation/antiplatelet Therapymentioning

confidence: 98%

Section: Anticoagulation/antiplatelet Therapymentioning

confidence: 99%

Left Main Coronary Artery Thrombus: A Case Series with Different Outcomes

Gupta

Rahman

Uretsky

et al. 2005

J Thromb Thrombolysis

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“…With the advances in PCI, some publications suggest the intracoronary thrombolysis for widespread thrombus in the LMCA 12 . Tissue plasminogen activator (tPA) and streptokinase, prolonged abciximab infusion with aspirin and heparin have been used effectively in individual cases with angiographic LMCA thrombus resolution 10, 12, 15, 18. Aspiration thrombectomy was used effectively in some cases 1, 2.…”

Section: Introductionmentioning

confidence: 99%

“… 12 Tissue plasminogen activator (tPA) and streptokinase, prolonged abciximab infusion with aspirin and heparin have been used effectively in individual cases with angiographic LMCA thrombus resolution. 10 , 12 , 15 , 18 Aspiration thrombectomy was used effectively in some cases. 1 , 2 Garcia et al 13 reported a successful case with manual thrombectomy.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of thrombotic left main coronary artery occlusions; old problem, different treatment approaches

Akçay

2018

Indian Heart Journal

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Thrombotic left main coronary artery (LMCA) occlusions usually manifest as acute coronary syndrome (ACS) with cardiogenic shock, acute pulmonary edema, cardiac arrest, fatal arrhythmias or sudden cardiac death. There is no clinically predictor for LMCA thrombosis and no consensus regarding the optimal treatment. In the current literature, treatment options include emergency coronary artery bypass grafting (CABG), stent implantation, intracoronary thrombolysis, anticoagulation with heparin or glycoprotein IIb/IIIa inhibitors, thrombus aspiration as reperfusion strategies. Recently, successful results have been reported with low dose, slow infusion tPA for treatment of LMCA thrombus that allowing coronary flow. This regime may be a new treatment idea in only hemodynamically stable patients. Prospective studies and common consensus are needed about the low dose, slow infusion tPA treatment regime and optimal treatment for thrombotic LMCA obstructions.

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