Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2018 May-Jun;70(3):446-449.
doi: 10.1016/j.ihj.2017.08.016. Epub 2017 Aug 26.

Intracoronary tenecteplase in STEMI with massive thrombus

P B Jayagopal  1 , Khadhar Mohamed Sarjun Basha  2
Affiliations
Case Reports

Intracoronary tenecteplase in STEMI with massive thrombus

P B Jayagopal et al. Indian Heart J. 2018 May-Jun.

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.

Keywords: Intracoronary thrombolysis; Myocardial infarction; massive thrombus; tenecteplase.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
(1a–5a) shows pre tenecteplase coronary angiogram & (1b–5b) shows corresponding post tenecteplase coronary angiogram. → indicates thrombus.
Fig. 2
Fig. 2
Shows initial frames (6a–9b) pre tenecteplase coronary angiogram revealing TIMI 1 flow & (6c–9c) shows corresponding post tenecteplase coronary angiogram. → indicates thrombus.
See this image and copyright information in PMC

References

    1. Frobert O., Lagerqvist B., Olivecrona G. Thrombus aspiration during ST-segment elevation myocardial infarction. N Engl J Med. 2013;369:1587–1597. - PubMed
    1. Jolly S.S., Cairns J., Yusuf S. Design and rationale of the TOTAL trial: a randomized trial of routine aspiration ThrOmbecTomy with percutaneous coronary intervention (PCI) versus PCI ALone in patients with ST-elevation myocardial infarction undergoing primary PCI. Am Heart J. 2014;167(3):315–321. - PubMed
    1. Boscarelli D., Vaquerizo B., Guardiola F.M. Intracoronary thrombolysis in patients with ST-segment elevation myocardial infarction presenting with massive intraluminal thrombus and failed aspiration. Eur Heart J: Acute Cardiovasc Care. 2014:1–8. - PubMed
    1. Kelly R.V., Crouch E., Krumnacher H. Safety of adjunctive intracoronary thrombolytic therapy during complex percutaneous coronary intervention: initial experience with intracoronary tenecteplase, Catheter Cardiovasc Interv. Catheter Cardiovasc Interv. 2005;66:327–332. - PubMed
    1. Abbas A.E., Brewington S.D., Dixon S.R. Intracoronary fibrin-Specific thrombolytic infusion facilitates percutaneous recanalization of chronic total occlusion. JACC. 2005;46(5):793–798. - PubMed

Publication types

MeSH terms

LinkOut - more resources