| CASE REPORT |
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| Year : 2018 | Volume
: 1
| Issue : 2 | Page : 143-147 |
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The multimodal use of thrombo-aspiration catheter during primary angioplasty using pharmaco-invasive strategy in coronary artery ectasia
Pankaj Jariwala1, Edla Arjun Padma Kumar1, Ajay Reddy2
1 Department of Cardiology, Maxcure-Mediciti Hospitals, Hyderabad, Telangana, India
2 Indira Nursing Home, Hyderabad, Telangana, India
Correspondence Address:
Dr. Pankaj Jariwala
Maxcure-Mediciti Hospitals, Opposite Secretariat, Hyderabad, Telangana, 500063
India
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/IHJI.IHJI_6_17
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Coronary artery ectasia is a unique form of the coronary artery disease, which when encountered poses therapeutic dilemma and difficulties in the management. The diffuse dilatation of coronary arteries involving more than two adjacent coronary segments commonly presents as acute coronary syndrome secondary to thrombotic and ischemic manifestations. Usually, primary angioplasty in the setting of coronary artery ectasia is a challenging task for interventional cardiologists as the entry of guide wire across the lesion secondary to slow flow, dilated segments, and large thrombus burden. Further, high chances of the no-reflow phenomenon and distal embolization of thrombus are additional challenges while performing primary angioplasty in the setting of coronary artery ectasia. We combined pharmacological method such as the injection of intracoronary tenecteplase and invasive approach using thrombo-aspiration catheter for visualization of mid- and distal segments of the vessel, the passage of guide wire, and dethrombosis. The novel therapeutic uses of thrombo-aspiration catheter included working as a multidomain technique for intracoronary delivery of drugs like perfusion balloon, injection of contrast like guide catheter, the passage of guide wire through stenosis like micro-catheter, and finally, as thrombo-aspiration as in the present case.
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