A 2-step optical coherence tomography guided therapeutic approach to acute myocardial infarction secondary to stent thrombosis

Cardiovasc Revasc Med. 2016 Jul-Aug;17(5):346-52. doi: 10.1016/j.carrev.2016.04.003. Epub 2016 May 4.

Abstract

Myocardial infarction secondary to stent thrombosis has high mortality and recurrence rate. Emergency PCI has high risk of no-reflow. We used a 2-step approach of early recanalization with minimal mechanical intervention followed by delayed PCI 1-2days later guided by Optical Coherence Tomography (OCT). From October 2011 to December 2013, we treated 5 patients with this approach. Time from early recanalization to the delayed definitive PCI was 1day (median, range 1-3days). All the OCT images were diagnostic with a clear view of the underlying structures.

Summary: A 2-step approach to treat stent thrombosis appears beneficial with low incidence of peri-procedural thrombosis or no-reflow phenomena during the second step, and superb OCT imaging.

Keywords: Acute myocardial infarction; Optical coherence tomography; Stent thrombosis.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Aged, 80 and over
  • Coronary Angiography
  • Coronary Thrombosis / diagnostic imaging
  • Coronary Thrombosis / etiology
  • Coronary Thrombosis / therapy*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction / diagnostic imaging
  • Myocardial Infarction / etiology
  • Myocardial Infarction / therapy*
  • Percutaneous Coronary Intervention / adverse effects
  • Percutaneous Coronary Intervention / instrumentation*
  • Platelet Aggregation Inhibitors / therapeutic use
  • Predictive Value of Tests
  • Retreatment
  • Stents*
  • Thrombectomy
  • Time Factors
  • Tomography, Optical Coherence*
  • Treatment Outcome

Substances

  • Platelet Aggregation Inhibitors