Trombüs aspirasyonuna sekonder gelişen bir komplikasyon: Yaygın sol sistem trombüsü ve başarılı yönetimi

Yıl 2019, Cilt: 12 Sayı: 1, 150 - 155, 28.04.2019

Özcan Örsçelik Mert Koray Özcan , Ali Orçun Sürmeli Buğra Özkan , İsmail Türkay Özcan Ahmet Çelik , Mehmet Necdet Akkuş

https://doi.org/10.26559/mersinsbd.404384

Öz

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.

Anahtar Kelimeler

trombüs aspirasyonu, yaygın sol sistem, başarılı yönetim, komplikasyon

A complication secondary to thrombus aspiration: Widespread left system thrombus and succesful management

Öz

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.

Anahtar Kelimeler

Thorombus aspiration, widespread left system thrombus, acute coronary syndrome, successful management, complication

Kaynakça

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