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Archives of cardiovascular diseases
Volume 105, n° 11
pages 616-618 (novembre 2012)
Doi : 10.1016/j.acvd.2011.07.006
Received : 10 June 2011 ;  accepted : 23 July 2011
Abciximab for distal thromboaspiration catheter-related embolization in ST-segment elevated myocardial infarction
Intérêt de l’abciximab pour l’embolisation coronaire distale liée au cathéter de thrombectomie dans l’infarctus du myocarde

Figure 1

Figure 1 : 

Panel A. Initial electrocardiogram (ECG) showing inferolateral ST-segment elevation with ST-segment depression in the anterior leads. Panel B. At admission to the intensive care unit after angioplasty, ECG showed minor persistent ST-segment elevation (0.1mV) in the inferolateral leads. Panels C and D. One hour later, we observed the onset of an accelerated idioventricular rhythm followed by ST-segment normalization.

Figure 2

Figure 2 : 

Panel A. Coronary angiography revealed proximal thrombotic occlusion of the left circumflex coronary artery (LCx), without collateral flow. Panel B. An intracoronary abciximab bolus (0.25mg/kg body weight) was given immediately after the diagnostic angiograms. Thrombectomy with the export aspiration catheter (Medtronic Corporation, California, USA) resulted in proximal reperfusion, however, distal embolization occurred. Panel C. Despite multiple attempts at thromboaspiration, the distal thromboembolus remained. Panel D. The patient underwent direct stenting of the proximal LCx with a bare-metal stent. Panel E. Thrombolysis in myocardial infarction (TIMI) grade flow was zero in the distal LCx. Panel F. Five days later, repeat coronary angiography confirmed complete resolution of the thrombus with TIMI 3 flow in the LCx.

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