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A Journal on Angiology

Official Journal of the International Union of Angiology, the International Union of Phlebology and the Central European Vascular Forum
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International Angiology 2001 September;20(3):244-7

language: English

Resolution of a spontaneous coronary artery thrombus with a new antiplatelet agent

Dagdelen S., Soydinc S., Ergelen M., Caglar N. *

From the Kosuyo­lu Heart and ­Research Hos­pi­tal
* Aci­ba­den Hos­pi­tal, Istan­bul, Tur­key


A throm­bus was ­observed in the left ante­ri­or descend­ing cor­o­nary ­artery in a 47 year-old woman who pre­sent­ed with acute ante­ri­or myo­car­dial infarc­tion. On a cor­o­nary angio­gram in the right ­oblique cra­ni­al posi­tion, the throm­bus ­appeared as an eccen­tric, solid and homo­ge­ne­ous mass with a 22 mm max­i­mal ­length and 1.9 mm max­i­mal diam­e­ter. The throm­bot­ic seg­ment and the rest of the cor­o­nary tree was free of ath­ero­scler­o­sis. Due to the inap­pro­pri­ate cor­o­nary struc­ture and ­length of the throm­bus, cor­o­nary angio­plas­ty and/or stent pro­ce­dures were not per­formed. The ­patient ­refused cor­o­nary ­artery by-pass. She was given the gly­co­pro­tein IIb/IIIa inhib­i­tor tirof­i­ban 0.4 µg . kg-1 . min-1 bolus over 30 min­utes fol­lowed by 0.1 µg . kg-1 . min-1 for 24 hours, oral­ly acet­yl­sal­i­cyl­ic acid 300 mg per day, nytro­glic­e­rin 40 mg per day and war­fa­rine with INR being in a range of 2-2.5 times. A con­trol cor­o­nary angio­gra­phy per­formed two ­months later ­showed total dis­so­lu­tion of the cor­o­nary throm­bus and clear­ance of the cul­prit ves­sel.

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