Case 109: PCI Manual - Large thrombus in a covid 19 patient

A patient with covid 19 presented with acute posterior myocardial infarction. Coronary angiography showed a large thrombus in the 2nd obtuse marginal branch. Unfractionated heparin and eptifibatide were administered. Thrombectomy with a Penumbra and an Export aspiration thrombectomy patient resulted in complete vessel occlusion. Balloon angioplasty restored antegrade flow in one of the distal branches. Repeat thrombectomy and balloon angioplasty eventually restored antegrade flow. No stents were implanted because the target vessel was small and did not have any significant residual lesions.

[schiefix]

Hardly a "very large thrombus" if the vessel is 1.5mm then...

[movvasrinivas]

Do you advise stenting in COVID, given the pro thrombotic state .
Is stent thrombosis more common in COVID ?

[shangz]

Thanks for your educative presentation.

[ero]

I have also done several cases with Pneumbra making things worse, and sometimes with improvement. Any advice on the best case to use it on ?

[georgetouma]

With radial intervention, what are your thoughts about a small dose of thrombolysis ?