Inadvertent coronary endarterectomy during aspiration thrombectomy with a Thrombuster III GR catheter in a patient with
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CASE REPORT
Inadvertent coronary endarterectomy during aspiration thrombectomy with a Thrombuster III GR catheter in a patient with acute coronary syndrome Eiji Taguchi • Tomohiro Sakamoto • Takihiro Kamio • Yoshihiro Kotono • Hiroto Suzuyama • Takashi Fukunaga Shinzo Miyamoto • Kazuhiro Nishigami • Koichi Nakao
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Received: 19 September 2012 / Accepted: 11 November 2012 / Published online: 30 November 2012 Ó Japanese Association of Cardiovascular Intervention and Therapeutics 2012
Abstract We describe a 41-year-old woman who presented with acute ST-segment elevation myocardial infarction. Emergent percutaneous intervention was performed with aspiration thrombectomy followed by coronary artery stenting. White material was extracted from the aspiration catheter. Reperfusion therapy after stenting was successful. After undergoing a cardiac rehabilitation program, she was discharged from hospital on day 10. Pathological examination revealed that the aspirated material consisted of normal vascular components including endothelial and smooth muscle cells. Aspiration thrombectomy is a commonly used procedure with a low complication rate. This case presents the previously unreported complication of coronary artery injury. Keywords Coronary endarterectomy Thrombectomy Acute coronary syndrome
(PCI) have been investigated to protect against embolization during the procedure [3–6]. Thrombus aspiration during PCI has been shown to achieve better reperfusion and clinical outcomes than conventional PCI without aspiration in patients with acute coronary syndrome (TAPAS trial) [7]. Use of a manual aspiration catheter can improve myocardial perfusion during primary PCI in patients with ST-segment elevation myocardial infarction [7, 8]. Thrombectomy catheters are now widely used for the pre-treatment of thrombotic coronary artery lesions in patients with acute coronary syndrome who are undergoing stenting. The reported complication rate is very low, and failure to advance the device across the target lesion is rare [4]. Histopathological examination of aspirated material often shows atherothrombotic material, mainly composed of platelets [7]. We present a case of aspiration of normal vascular wall material, which has not previously been reported.
Introduction Case report In patients with ST-segment elevation myocardial infarction, atherothrombotic material may embolize from unstable plaques [1, 2]. Various devices for aspiration thrombectomy during percutaneous coronary intervention
E. Taguchi (&) T. Sakamoto Y. Kotono H. Suzuyama T. Fukunaga S. Miyamoto K. Nishigami K. Nakao Division of Cardiology, Cardiovascular Center, Saiseikai Kumamoto Hospital, 5-3-1 Chikami, Minami-ku, Kumamoto 861-4193, Japan e-mail: [email protected] T. Kamio Division of Pathology, Laboratory Center, Saiseikai Kumamoto Hospital, Kumamoto, Japan
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A 41-year-old woman was referred to our hospital in August 2010 because of persistent chest pain. She was previously healthy with no history of cardiac disease, but was a c
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