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Int J Angiol 2023; 32(02): 143-145
DOI: 10.1055/s-0041-1740319
Case Report

Novel Use of Dual Guiding Catheters Technique to Prevent Distal Embolization and Slow Flow during PCI of Coronary Stent Thrombosis

Vijay Kumar Trehan
1   Department of Cardiology, G.B. Pant Hospital, New Delhi, India
,
Gagan Jain
2   Department of Cardiology, Janakpuri Super Speciality Hospital, New Delhi, India
,
Puneet Gupta
2   Department of Cardiology, Janakpuri Super Speciality Hospital, New Delhi, India
› Author Affiliations Funding None.
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Abstract

Despite having an incidence of 0.5 to 2%, stent thrombosis has an in-hospital mortality of 15% and myocardial infarction (MI) incidence of 67%. Even with the usage of thrombus aspiration devices and microvasculature vasodilators such as nitroprusside, verapamil, adenosine, and Gp2b/3a inhibitors, the angiographic result of percutaneous coronary intervention of coronary stent thrombosis remains frequently suboptimal due to distal embolization and subsequent slow flow. We describe a novel use of dual guide catheter technique, where one guide acts as conduit for thrombus aspiration catheter and the other for distal placement of balloon trap to prevent distal embolization while managing a case of coronary stent thrombosis to improve the angiographic outcome in this scenario.

Keywords

stent - PCI - myocardial infarction - coronary stent - coronary artery - guiding catheter

Ethical Approval

This article does not contain any studies with human participants or animals performed by any of the authors.


Informed Consent

Written informed consent was received from the patient for the procedure done.


Consent for Publication

For this type of manuscript consent for publication is not required.




Publication History

Article published online:
31 December 2021

© 2021. International College of Angiology. This article is published by Thieme.

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  • References

  • 1 Uren NG, Schwarzacher SP, Metz JA. et al; POST Registry Investig. Predictors and outcomes of stent thrombosis: an intravascular ultrasound registry. Eur Heart J 2002; 23 (02) 124-132
    CrossrefPubMedGoogle Scholar
  • 2 Cutlip DE, Windecker S, Mehran R. et al; Acad Res Consort. Clinical end points in coronary stent trials: a case for standardized definitions. Circulation 2007; 115 (17) 2344-2351
    CrossrefPubMedGoogle Scholar
  • 3 Ben-Gal Y, Weisz G, Collins MB. et al. Dual catheter technique for the treatment of severe coronary artery perforations. Catheter Cardiovasc Interv 2010; 75 (05) 708-712
    CrossrefPubMedGoogle Scholar
  • 4 Jolly SS, James S, Džavík V. et al. Thrombus aspiration in ST-segment-elevation myocardial infarction: an individual patient meta-analysis: Thrombectomy trialists collaboration. Circulation 2017; 135 (02) 143-152
    CrossrefPubMedGoogle Scholar