PMC9386044_01
Electrocardiograms. (A,B) In the emergency room. (C) After intracoronary artery retrograde thrombolysis (ICART).
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F1
ST-segment elevations in leads II, III, aVF, V3R, V4R, and V5R (Figures 1A,B). Serum creatinine was 73 mumol/L, and serum troponin T was 7.97 ng/ml. TIMI grade 3 (Figure 2D). The chest pain was completely relieved, and the ST-segment elevation was resolved (Figure 1C).
Coronary angiogram of acute circumflex artery occlusion. (A) Basal angiogram showing total occlusion of the left the circumflex artery (LCX) distal segment with thrombus image. The arrow shows the occlusion. (B) Procedure of intracoronary artery retrograde thrombolysis (ICART) through the cut balloon. The distal thrombus was gradually dissolved. The fine arrow shows the tip of the cut balloon, and the coarse arrow indicates the thrombolytic agent with contrast agent to fill the occluded lumen. (C) The distal end of the LCX was dilated up to 5 atm with a 2 mm x 20 mm compliant balloon. (D) Revascularization was achieved at the distal end of the LCX without stent implantation.
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F2
The CAG showed that the left circumflex (LCX) was completely occluded by a large amount of thrombus in the distal portion (Figure 2A). Then, the balloon was inserted over the Runthrough guidewire and through the stenotic section of the occluded coronary artery (Figure 2B). Following this, 1 ml of the cocktail was bolus-injected through the cut balloon, which was repeated every 30 s (Figure 2B). The occluded segment was dilated up to 5 atm with a 2 mm x 20 mm Sprinter Legend compliant balloon (Figure 2C) at the distal portion of the LCX. TIMI grade 3 (Figure 2D). The chest pain was completely relieved, and the ST-segment elevation was resolved (Figure 1C).