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2017, Number 5

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Rev Sanid Milit Mex 2017; 71 (5)

Usefulness of intracoronary infusion of alteplase with microcatheter in acute coronary syndromes

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

Language: Spanish
References: 23
Page: 429-436
PDF size: 329.69 Kb.


ABSTRACT

The management of intracoronary thrombus remains a challenge to the interventional cardiologist. Continuous thrombus formation, inadequate assessment of vessel diameter and plaque length, and distal embolization are adverse factors in this setting. In this paper, we present a novel strategy for coronary thrombus management with intracoronary alteplase using a microcatheter at a 1 mg/h dose for 12 hours. Sixteen patients were assigned to alteplase infusion and 15 to the conventional strategy. In the alteplase group, 50% of patients had TIMI 0 thrombus, versus 40% with TIMI 2 thrombus in the conventional group. In the alteplase group, eight stents were used, compared with 22 stents in the conventional group. The mean stent length was 18.4 ± 2.84 mm in the alteplase group and 21.45 ± 3.09 mm in the conventional group. No no-reflow cases were observed in the alteplase group, versus four cases in the conventional group. There were no hemorrhagic complications in either group. This method may be a valid strategy for the management of coronary thrombus.


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