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2017, Número 5

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Rev Sanid Milit Mex 2017; 71 (5)


Utilidad de la infusión intracoronaria de alteplase con microcatéter en el síndrome coronario agudo

Gutiérrez LH, Iñarra TF, Hernández CAS, Galván VCG, Valenzuela HJC, Chávez OJA

Idioma: Español
Referencias bibliográficas: 23
Paginas: 429-436
Archivo PDF: 329.69 Kb.


RESUMEN

El manejo del trombo intracoronario es un reto para el cardiólogo intervencionista. La continua formación de trombo, la inadecuada valoración del diámetro del vaso y longitud de placa, y la embolización distal complican el éxito en estos casos. En este trabajo se presenta una estrategia novedosa de manejo del trombo con la infusión intracoronaria de alteplase mediante microcatéter. Se asignaron 16 pacientes a recibir infusión intracoronaria de alteplase a razón de 1 mg/h por 12 horas, y 15 pacientes a tratamiento convencional con angioplastia primaria. En el grupo de alteplase, 50% de los pacientes presentaron trombo TIMI 0, contra 40% de los pacientes con carga de trombo TIMI 2. En el grupo de alteplase se utilizaron ocho stents en total, comparado con 22 en el grupo convencional. La longitud del stent también fue menor en el grupo de alteplase, con un promedio de 18.4 ± 2.84 mm, contra 21.45 ± 3.09 mm en el grupo convencional. En el grupo de alteplase no se observaron casos de fenómeno de no reflujo, y en el grupo convencional se presentaron cuatro casos. No hubo complicaciones hemorrágicas en ambos grupos. Este método puede ser una estrategia válida para el manejo del trombo coronario.


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