Bitigen Atilla, Gurel Emre, Tanalp Ali Cevat, Aung Soe Moe, Başaran Yelda
Department of Cardiology, Kartal Kosuyolu Heart Education and Research Hospital, Istanbul;
Exp Clin Cardiol. 2007 Winter;12(4):203-5.
A 75-year-old man, with a previous history of myocardial infarction and three-vessel coronary artery bypass grafting, presented with an acute anterior ST-elevation myocardial infarction. The vein graft to the left anterior descending artery was occluded with heavy thrombus burden, and the other grafts were patent. After administering a bolus dose of tirofiban and then undergoing percutaneous coronary intervention without stenting to the left anterior descending artery saphenous vein graft, intracoronary thrombolytic infusion was performed to maintain the patency of the vein graft. The patient was asymptomatic after medical follow-up. This may be an effective treatment option in patients with large thrombus burden and requires further investigation through large-scale trials.
一名75岁男性，既往有心肌梗死病史且接受过三支冠状动脉搭桥术，现出现急性前壁ST段抬高型心肌梗死。左前降支静脉桥血管被大量血栓阻塞，其他桥血管通畅。在静脉推注替罗非班后，对左前降支大隐静脉桥血管进行了无支架的经皮冠状动脉介入治疗，随后进行冠状动脉内溶栓输注以维持静脉桥血管通畅。经医学随访，患者无症状。这可能是血栓负荷大的患者的一种有效治疗选择，需要通过大规模试验进一步研究。
