Author + information
- Received September 22, 2011
- Accepted September 27, 2011
- Published online March 20, 2012.
A 50-year-old man with a history of diabetes and a thymoma was referred for cardiac catheterization after the finding of anterior-wall ischemia on a pre-operative stress test. Coronary angiography revealed a significant stenosis of the mid-left anterior descending coronary artery. Unfractionated heparin (70 IU/kg) and 600 mg of clopidogrel were administered before intervention with 2 overlapping bare-metal stents (A, arrows). Post–percutaneous coronary intervention optical coherence tomography (OCT) showed circumferential, platelet-rich thrombus inside the stents (B, arrows). Before abciximab could be given, he experienced sudden-onset chest discomfort. Subsequent coronary angiography demonstrated acute thrombotic occlusion (C, arrow). Coronary thrombectomy followed by angioplasty were performed. Repeat coronary angiography and OCT (D) after 24 h of intravenous antithrombotic therapy demonstrated near-complete resolution of the thrombus, an in vivo demonstration of intracoronary platelet disaggregation by a glycoprotein IIb/IIIa receptor antagonist, confirmed by OCT.
Dr. Jang has received grant/consulting support from St. Jude Medical.
- Received September 22, 2011.
- Accepted September 27, 2011.
- American College of Cardiology Foundation