Mark Kheifets: A Massive Stent Thrombosis Requiring Aspiration Thrombectomy
Mark Kheifets, Interventional Cardiologist at Beilinson – Rabin Medical Center, shared a post on LinkedIn:
”Our three most dangerous foes in interventional cardiology are air, calcium & clot. Every once in a while you encounter a case that features a truly vicious opponent:
A 61 year-old male patient with a history of IHD (s/p PCI to LAD, RCA and OM) dyslipidemia and active smoking. Latest intervention to proximal LAD occurred in 8.2024. He now presented with an anterior STEMI. Onset of symptoms began approximately 1-hour before arrival to the cath lab. Angiogram revealed an occluded LAD with proximal stent thrombosis.
The thrombotic mass was truly massive and required the use of an aspiration catheter. Multiple runs of aspiration thrombectomy were performed, yielding both red amd white thrombus.
A 3.5 by 15 DES was deployed (overlapping with the previous stent) and 3.75 by 8 NC was used.
Adenosine (200 mcg) and IIBIIIA inhibitors (bolus by 2 followed by a 12 hour drip) were also administered
The patient was safely transferred to the CICU.
Aspiration thrombectomy should not be routinely used, but we must always remember that it is an essential part of our toolkit.
Clot images in first comment…”
Proceed to the video attached to the post.
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