Rapid Dissolution of Massive Intracoronary Thrombosis With Platelet Glycoprotein IIb/IIIa Receptor Inhibitor
This 56-year-old man presented with unstable angina and acute pulmonary edema. He underwent cardiac catheterization, which revealed extensive thrombotic occlusion of the mid left anterior descending coronary artery (LAD), the second diagonal branch, and the second septal perforating branch (Figure 1⇓). Recanalization of the mid-LAD with a long perfusion balloon after abciximab (Reopro) was planned. Abciximab 25 mg IV (0.25 mg/kg) was administered. Five minutes later, the first control angiogram demonstrated a complete clearance of the thrombotic material of the mid-LAD. Recanalization of the second diagonal and the second septal perforating branches with transient distal embolization to the second diagonal branch occurred (Figure 2⇓). No balloon dilatation was necessary. Continued therapy consisted of abciximab infusion for 12 hours, aspirin, and intravenous heparin. Heparin was eventually replaced by warfarin. At 1-year follow-up, no evidence of ischemia was present.
The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke’s Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.
Circulation encourages readers to submit cardiovascular images to Dr Hugh A. McAllister, Jr, St Luke’s Episcopal Hospital and Texas Heart Institute, 6720 Bertner Ave, MC1-267, Houston, TX 77030.
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