Trombüs aspirasyonuna sekonder gelişen bir komplikasyon: Yaygın sol sistem trombüsü ve başarılı yönetimi
Abstract
Akut koroner sendromlarda (miyokard infarktüsü, kararsız
angina) intrakoroner trombüs görülme oranı yüksektir. Miyokard infaktüsü ile
gelen hastalarda intrakoroner trombüs mevcudiyeti güncel müdahale tekniklerine
rağmen işlem başarısını düşürmekte ve çeşitli komplikasyonlara neden
olmaktadır. Bizim vakamızda 49 yaşında erkek hastada gelişen komplikasyonlar ve
yönetimi sunulmuştur. ST elevasyonlu miyokard infarktüsü ile gelen hastanın son
ön inen koroner arterde trombüsün aspirasyonu sonrası tüm sol sistemde yaygın
trombüs gözlemlendi. İntrakoroner heparin ve tirofiban sonrasında trombüs
geriledi ve direkt stent implantasyonu ile kompikasyon başarılı bir şekilde
yönetildi. Son kılavuzlarda da gösterildiği üzere trombüs aspirasyonu, yoğun
koroner arter trombüsü olması durumunda mortaliteyi istatistiksel olarak
anlamlı olmasa da azalttığı gösterilmiş ancak koroner arter trombüs aspirasyonu
rutin olarak önerilmemektedir.
References
- 1.Kragel AH, Gertz SD, Roberts WC: Morphologic comparison of frequency and types of acute lesions in the major epicardial coronary arteries in unstable angina pectoris, sudden death and acute myocardial infarction. J Am Coll Cardiol 1991; 18:801-8
- 2.Timurkaynak T, Özdemir M, Çengel A, et al:Direct stenting in angiographically apparent thrombus containing lesions. J lnvasive Cardiol 2001;13:742 7
- 3.Zhao XQ, Theroux P, Snapinn SM, Sax FL: Intracoronary thrombus and platelet glycoprotein IIb/IIIa receptor blockade with tirofiban in unstable angina or non-Q-wave myocardiaJ infarction. Angiographic results from the PRISM-PLUS trial (Platelet receptor inhibition for ischemic syndrome management in patients limited by unstable signs and symptoms). PRISM-PLUS lnvestigators.Circulation 1999; 100: 1609- 15
- 4.Timurkaynak T, Cemri M, Özdemir M, Yalçın R, Çengel A, Dörtlemez O. Adjunctive therapies in the cath Iab. lntracoronary tirofiban infusion in a case with massive intracoronary thrombus . J lnvasive Cardiol 2001; 13: 654-6
- 5.lschinger T: Thrombectomy with the X-SIZER catheter system in the coronary circulation:initial results from a multi-center study. J Invasive Cardiol 2001;13:81-8
- 6.Brosh D, Rosenschein U: Catheter-based ultrasound thrombolysis--a new promising thrombus-debulking device for the treatment of intracoronary thrombosis. Semin Interv Cardiol 2000;5: 149-55
- 7.Nakagawa Y, Matsuo S, Kimura T, et al: Thrombectomy with AngioJet catheter in native coronary arteries for patients with acute or recent myocardial infarction. Am J Cardiol 1999;83:994-9
- 8. Jolly SS, Cairns JA, Yusuf S, Meeks B, Pogue J, Rokoss MJ, Kedev S, Thabane L, Stankovic G, Moreno R, Gershlick A, Chowdhary S, Lavi S, Niemela K, Steg PG, Bernat I, Xu Y, Cantor WJ, Overgaard CB, Naber CK, Cheema AN, Welsh RC, Bertrand OF, Avezum A, Bhindi R, Pancholy S, Rao SV, Natarajan MK, ten Berg JM, Shestakovska O, Gao P, Widimsky P, Dzavik V, TOTAL Investigators. Randomized trial of primary PCI with or without routine manual thrombectomy. N Engl J Med 2015;372(15):1389–1398
- 9. Frobert O, Lagerqvist B, Olivecrona GK, Omerovic E, Gudnason T, Maeng M, Aasa M, Angeras O, Calais F, Danielewicz M, Erlinge D, Hellsten L, Jensen U, Johansson AC, Karegren A, Nilsson J, Robertson L, Sandhall L, Sjogren I, Ostlund O, Harnek J, James SK, TASTE Trial. Thrombus aspiration during STsegment elevation myocardial infarction. N Engl J Med 2013;369(17):1587–1597
- 10. Sanjit S. Jolly, Stefan James, Vladimír Džavík, John A. Cairns, Karim D. Mahmoud, Felix Zijlstra, Salim Yusuf, Goran K. Olivecrona, Henrik Renlund, Peggy Gao, Bo Lagerqvist, Ashraf Alazzoni, Sasko Kedev, Goran Stankovic, Brandi Meeks, Ole Frøbert. An Individual Patient Meta-Analysis: Thrombectomy Trialists Collaboration. Circulation. 2017;135:143-152, doi.org/10.1161/CIRCULATIONAHA.116.025371
A complication secondary to thrombus aspiration: Widespread left system thrombus and succesful management
Abstract
The incidence of intracoronary thrombosis is high in
acute coronary syndromes. Despite the current intervention techniques, the
presence of intracoronary thrombus in patients with myocardial infarction,
decreases the success of the procedure and causes various complications. We
present the complications and management in a 49-year-old male patient. A
common thrombus was observed in the left whole system after aspiration of the
thrombus in the left anterior descending coronary artery of the patient with ST
elevation myocardial infarction.
tirofiban, and the complication was successfully managed with direct stent
implantation. Thrombus aspiration has been shown to reduce mortality in the
case of intense coronary artery thrombosis, although not statistically
significant, as shown in recent guidelines, but coronary artery thrombus
aspiration is not routinely recommended.
Keywords
Thorombus aspiration widespread left system thrombus acute coronary syndrome successful management complication
References
- 1.Kragel AH, Gertz SD, Roberts WC: Morphologic comparison of frequency and types of acute lesions in the major epicardial coronary arteries in unstable angina pectoris, sudden death and acute myocardial infarction. J Am Coll Cardiol 1991; 18:801-8
- 2.Timurkaynak T, Özdemir M, Çengel A, et al:Direct stenting in angiographically apparent thrombus containing lesions. J lnvasive Cardiol 2001;13:742 7
- 3.Zhao XQ, Theroux P, Snapinn SM, Sax FL: Intracoronary thrombus and platelet glycoprotein IIb/IIIa receptor blockade with tirofiban in unstable angina or non-Q-wave myocardiaJ infarction. Angiographic results from the PRISM-PLUS trial (Platelet receptor inhibition for ischemic syndrome management in patients limited by unstable signs and symptoms). PRISM-PLUS lnvestigators.Circulation 1999; 100: 1609- 15
- 4.Timurkaynak T, Cemri M, Özdemir M, Yalçın R, Çengel A, Dörtlemez O. Adjunctive therapies in the cath Iab. lntracoronary tirofiban infusion in a case with massive intracoronary thrombus . J lnvasive Cardiol 2001; 13: 654-6
- 5.lschinger T: Thrombectomy with the X-SIZER catheter system in the coronary circulation:initial results from a multi-center study. J Invasive Cardiol 2001;13:81-8
- 6.Brosh D, Rosenschein U: Catheter-based ultrasound thrombolysis--a new promising thrombus-debulking device for the treatment of intracoronary thrombosis. Semin Interv Cardiol 2000;5: 149-55
- 7.Nakagawa Y, Matsuo S, Kimura T, et al: Thrombectomy with AngioJet catheter in native coronary arteries for patients with acute or recent myocardial infarction. Am J Cardiol 1999;83:994-9
- 8. Jolly SS, Cairns JA, Yusuf S, Meeks B, Pogue J, Rokoss MJ, Kedev S, Thabane L, Stankovic G, Moreno R, Gershlick A, Chowdhary S, Lavi S, Niemela K, Steg PG, Bernat I, Xu Y, Cantor WJ, Overgaard CB, Naber CK, Cheema AN, Welsh RC, Bertrand OF, Avezum A, Bhindi R, Pancholy S, Rao SV, Natarajan MK, ten Berg JM, Shestakovska O, Gao P, Widimsky P, Dzavik V, TOTAL Investigators. Randomized trial of primary PCI with or without routine manual thrombectomy. N Engl J Med 2015;372(15):1389–1398
- 9. Frobert O, Lagerqvist B, Olivecrona GK, Omerovic E, Gudnason T, Maeng M, Aasa M, Angeras O, Calais F, Danielewicz M, Erlinge D, Hellsten L, Jensen U, Johansson AC, Karegren A, Nilsson J, Robertson L, Sandhall L, Sjogren I, Ostlund O, Harnek J, James SK, TASTE Trial. Thrombus aspiration during STsegment elevation myocardial infarction. N Engl J Med 2013;369(17):1587–1597
- 10. Sanjit S. Jolly, Stefan James, Vladimír Džavík, John A. Cairns, Karim D. Mahmoud, Felix Zijlstra, Salim Yusuf, Goran K. Olivecrona, Henrik Renlund, Peggy Gao, Bo Lagerqvist, Ashraf Alazzoni, Sasko Kedev, Goran Stankovic, Brandi Meeks, Ole Frøbert. An Individual Patient Meta-Analysis: Thrombectomy Trialists Collaboration. Circulation. 2017;135:143-152, doi.org/10.1161/CIRCULATIONAHA.116.025371
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Articles |
| Authors | |
| Publication Date | April 28, 2019 |
| Submission Date | March 12, 2018 |
| Acceptance Date | January 2, 2019 |
| Published in Issue | Year 2019 Volume: 12 Issue: 1 |
Cite
MEU Journal of Health Sciences Assoc was began to the publishing process in 2008 under the supervision of Assoc. Prof. Gönül Aslan, Editor-in-Chief, and affiliated to Mersin University Institute of Health Sciences. In March 2015, Prof. Dr. Caferi Tayyar Şaşmaz undertook the Editor-in Chief position and since then he has been in charge.
Publishing in three issues per year (April - August - December), it is a multisectoral refereed scientific journal. In addition to research articles, scientific articles such as reviews, case reports and letters to the editor are published in the journal. Our journal, which has been published via e-mail since its inception, has been published both online and in print. Following the Participation Agreement signed with TÜBİTAK-ULAKBİM Dergi Park in April 2015, it has started to accept and evaluate online publications.
Mersin University Journal of Health Sciences have been indexed by Turkey Citation Index since November 16, 2011.
Mersin University Journal of Health Sciences have been indexed by ULAKBIM Medical Database from the first issue of 2016.
Mersin University Journal of Health Sciences have been indexed by DOAJ since October 02, 2019.
Article Publishing Charge Policy: Our journal has adopted an open access policy and there is no fee for article application, evaluation, and publication in our journal. All the articles published in our journal can be accessed from the Archive free of charge.
This work is licensed with Attribution-NonCommercial 4.0 International.