Successful Revascularization of Coronary Artery Occluded by Massive Intracoronary Thrombi with Alteplase and Percutaneous Coronary Intervention

Jeong Su Kim; June Hong Kim; Hyung Ha Jang; Yong Whan Lee; Sung Gook Song; Ju Hyun Park; Kook Jin Chun

doi:10.5551/jat.4283

Case Report

Successful Revascularization of Coronary Artery Occluded by Massive Intracoronary Thrombi with Alteplase and Percutaneous Coronary Intervention

Jeong Su Kim, June Hong Kim, Hyung Ha Jang, Yong Whan Lee, Sung Gook Song, Ju Hyun Park, Kook Jin Chun

Author information

Jeong Su Kim
Department of Internal Medicine, Pusan National University School of Medicine.
Division of Cardiology, Cardiovascular Center, Pusan National University Yangsan Hospital.
June Hong Kim
Department of Internal Medicine, Pusan National University School of Medicine.
Division of Cardiology, Cardiovascular Center, Pusan National University Yangsan Hospital.
Hyung Ha Jang
Department of Internal Medicine, Pusan National University School of Medicine.
Division of Cardiology, Cardiovascular Center, Pusan National University Yangsan Hospital.
Yong Whan Lee
Department of Internal Medicine, Pusan National University School of Medicine.
Division of Cardiology, Cardiovascular Center, Pusan National University Yangsan Hospital.
Sung Gook Song
Department of Internal Medicine, Pusan National University School of Medicine.
Division of Cardiology, Cardiovascular Center, Pusan National University Yangsan Hospital.
Ju Hyun Park
Department of Internal Medicine, Pusan National University School of Medicine.
Division of Cardiology, Cardiovascular Center, Pusan National University Yangsan Hospital.
Kook Jin Chun
Department of Internal Medicine, Pusan National University School of Medicine.
Division of Cardiology, Cardiovascular Center, Pusan National University Yangsan Hospital.

Keywords: Myocardial infarction, Thrombolytic therapy, Percutaneous Transluminal Coronary Angioplasty

JOURNAL OPEN ACCESS

2010 Volume 17 Issue 7 Pages 768-770

DOI https://doi.org/10.5551/jat.4283

View "Advance Publication" version (May 12, 2010).

Details

Abstract

A 67-year-old man was admitted to our institution with sudden and pessistant chest pain for 3 days. Coronary angiography showed massive thrombotic occlusion of the right coronary artery. The patient received intracoronary thrombolysis with alteplase (recombinant tissue-type plasminogen activator, rt-PA). On repeated angiography, there was marked resolution of intracoronary thrombus. After percutaneous coronary intervention with stent implantation, the final result was complete revascularization of the right coronary artery (TIMI grade 3 distal flow). This case demonstrates that intracoronary rt-PA can result in local thrombus reduction in patients undergoing PCI, especially with a large thrombus burden.

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