Lad guideliner1/8/2024 ![]() Right femoral artery access was gained using an 8 Fr sheath, and an 8 Fr extra back-up 3.75 guide catheter was used to intubate the LAD. The PCI was performed to recanalize the occluded LAD. Emergency coronary angiography revealed no significant stenosis in the right coronary artery, while the left anterior descending artery (LAD) showed an acute thrombotic occlusion in the mid-section ( Figure 2A). The patient remained haemodynamically stable (Killip 1) with normal blood pressure (110/70 mmHg) and heart rate, without the need for drug support. Blood tests showed the troponin level to be as low as 50–100 ng/L. The electrocardiogram revealed an ST-segment elevation in the V2-6 leads ( Figure 1) and echocardiography showed anteroseptal hypokinesis, indicating an anterior ST-elevation myocardial infarction (STEMI). ![]() TimelineĪn 80-year-old man with a history of myocardial infarction, paroxysmal atrial fibrillation, and dyslipidaemia was admitted to our hospital complaining of persistent chest pain. Here, we present a case of successful massive thrombus retrieval by capturing it between the tip of the GuideLiner ® Catheter (Vascular Solutions Inc., Minneapolis, MN, USA) and the filter body of the Filtrap ® (Nipro Corporation., Nagoya, Japan). 2, 3 In some cases, thrombus aspiration results in successful retrieval of the thrombotic material leaving the culprit lesion without any residual stenosis, especially in patients with atrial fibrillation. 1 Thrombus aspiration using dedicated catheters and ‘Mother-in-child’ thrombectomy technique may be used in patients presenting with AMI and large thrombus burdens in PCI. Large thrombus burdens, distal embolization and a slow flow/no flow are sometimes encountered during the PCI which is associated with worse outcomes. Primary percutaneous coronary intervention (PCI) is the preferred and effective reperfusion strategy for acute myocardial infarction (AMI). This method is effective in removing refractory thrombi for the treatment of ST-elevation myocardial infarction patients. Successful retrieval of a massive thrombus by capturing it between the tip of GuideLiner ® and the filter body of a Filtrap ®. Removal of large coronary artery thrombi with the use of an aspiration catheter can at times prove difficult.
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