Huge thrombus burden.
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- čas přidán 6. 07. 2021
- STEMI. Left dominance. Ectasia.
Manual aspiration tried many times but failed.
Pre dilation with SC but failed to restore the flow.
Trifurcation.
Tip injection across the thrombus shows good distal flow.
Decided to stent from LCX to LPL.
PING-PONG guide.
For trifurcation KBD.
Good flow to distal vessel but still significant thrombus burden.
Gb IIb/IIIa started.
TAT for 6 week then we angio Timi III flow without any thrombus and patent stent.
DAT therapy at discharge.
In acute left coronary artery myocardial infarction, the first step in performing thrombus aspiration is to insert a guidewire into the anterior descending branch and the circumflex branch respectively. This is because if the thrombus drops from the circumflex branch into the anterior descending branch during thrombus aspiration, the consequences would be catastrophic. Additionally, intracoronary injection of drugs such as tirofiban or abciximab has also been shown to be effective.
Heparin and GP2B3A would have made life easier
The proximal edge of stent is undersized as compared to vessel size no matter Extensive balloning done
Anyone in the group who would give intracoronary TNK? If yes, what dose?
Btw excellent result. Please post your pharmacologic therapy during the case besides IV heparin.
Have you considered option of POBA followed by intracoronary thrombolysis with TNK in this patient?
No
Marvellouse
I think TNK IC is better option right?
What do you think and want to tell us my dear👍
Salam.
Sir.
H r u.
Sir please if u don't mind.
My Cardiologist
Repeat 3rd LHC, IVUS,FFR,
Results ye hain.
Why don't tell us what you did?
Can you tell us what you did?
very nicely done, but definite risk of slow flow or no reflow
Yes agreed
Sir please your Expert Opinion my case.
Thanks.
Regards.
Ejaz Ahmed.
Send your case.
Haven't been able to see your case.
@@drimranhanifhashmi5442
Asalam.o.Alaikum
Sir.
H r u.
Thanks a lot.
Sir I m 45 year old H/o Last 9 year HTN DM2.
Spinal surgery L4/L5 & L5 /D1 2014.
Family History IHD,MI positive.
Last 6 month waking chest pain.chest heaviness & SOB.
3 episode Angiography
4 May 2021
1 July 2021
10 August 2021
2 Angioplasty.
10 August LHC IVUS FFR showed.
Final Diagnose,
2V-CAD-POBA to D2.
LM→Normal.
LAD→Proximal 60% lesion-D2 80% Ostieal Lesion.
LCX→Distal 40% diffuse disease, previously deployed stent.
RCA→Proximal 50% Lesion.R PDA severe diffuse disease.
FFR→0.85
@@ejazahmed2476
It's better if you meet me in person with your records.
Do you have rotablator facility in ur hospital?
Yes you can see rota cases at this Chanel.