Frontiers in Cardiovascular Medicine (Jul 2022)

Intracoronary artery retrograde thrombolysis combined with percutaneous coronary interventions for ST-segment elevation myocardial infarction complicated with diabetes mellitus: A case report and literature review

  • Mingzhi Shen,
  • Mingzhi Shen,
  • Yichao Liao,
  • Jian Wang,
  • Xinger Zhou,
  • Xinger Zhou,
  • Yuting Guo,
  • Yuting Guo,
  • Yingqiao Nong,
  • Yingqiao Nong,
  • Yi Guo,
  • Haihui Lu,
  • Rongjie Jin,
  • Jihang Wang,
  • Zhenhong Fu,
  • Dongyun Li,
  • Shihao Zhao,
  • Jinwen Tian,
  • Jinwen Tian

DOI
https://doi.org/10.3389/fcvm.2022.962127
Journal volume & issue
Vol. 9

Abstract

Read online

BackgroundThe management of a large thrombus burden in patients with acute myocardial infarction and diabetes is still a worldwide problem.Case presentationA 74-year-old Chinese woman presented with ST-segment elevation myocardial infarction (STEMI) complicated with diabetes mellitus and hypertension. Angiography revealed massive thrombus formation in the mid-segment of the right coronary artery leading to vascular occlusion. The sheared balloon was placed far from the occlusion segment and urokinase (100,000 u) was administered for intracoronary artery retrograde thrombolysis, and thrombolysis in myocardial infarction (TIMI) grade 3 blood flow was restored within 7 min. At last, one stent was accurately implanted into the culprit’s vessel. No-reflow, coronary slow flow, and reperfusion arrhythmia were not observed during this process.ConclusionIntracoronary artery retrograde thrombolysis (ICART) can be effectively and safely used in patients with STEMI along with diabetes mellitus and hypertension, even if the myocardial infarction exceeds 12 h (REST or named ICART ClinicalTrials.gov number, ChiCTR1900023849).

Keywords