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.

Keywords

• trombüs aspirasyonu,yaygın sol sistem,başarılı yönetim,komplikasyon

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. 

Thrombosis regressed after intracoronary heparin and 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

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