Intracoronary thrombolysis combined with drug balloon angioplasty in a young ST-segment elevation myocardial infarction patient:A case report  

作　　者：Li-Qiong She De-Kui Gao Le Hong Yin Tian Hui-Zhen Wang Sheng Huang 

机构地区：[1]Department of Critical Care Medicine,Jiangyou Second People's Hospital,Jiangyou 621701,Sichuan Province,China [2]Department of Cardiology,Jiangyou Second People's Hospital,Jiangyou 621701,Sichuan Province,China [3]Department of Interventional Medicine,Jiangyou Second People's Hospital,Jiangyou 621701,Sichuan Province,China

出　　处：《World Journal of Cardiology》2024年第9期531-541,共11页世界心脏病学杂志（英文版）（电子版）

基　　金：Supported by Mianyang Health Commission 2019 Scientific Research Encouragement Project,No.201948.

摘　　要：BACKGROUND The combination of acute ST-segment elevation myocardial infarction(STEMI)and gastric ulcers poses a challenge to primary percutaneous coronary intervention(PPCI),particularly for young patients.The role of drug-coated balloons(DCBs)in the treatment of de novo coronary artery lesions in large vessels remains unclear,especially for patients with STEMI.Our strategy is to implement drug balloon angioplasty following the intracoronary administration of low-dose prourokinase and adequate pre-expansion.CASE SUMMARY A 54-year-old male patient presented to the emergency department due to chest pain on June 24,2019.Within the first 3 minutes of the initial assessment in the emergency room,the electrocardiogram(ECG)showed significant changes.There was atrial fibrillation with ST-segment elevation.Subsequently,atrial fibrillation terminated spontaneously and reverted to sinus rhythm.Soon after,the patient experienced syncope.The ECG revealed torsades de pointes ventricular tachycardia.A few seconds later,it returned to sinus rhythm.High-sensitivity tropon in I was normal.The diagnosis was acute STEMI.Emergency coronary angiography revealed subtotal occlusion with thrombus formation in the proximal segment of the left anterior descending artery.Considering the patient's age and history of peptic ulcer disease,after the intracoronary injection of prourokinase,percutaneous transluminal coronary angioplasty and cutting balloon angioplasty were conducted for thorough preconditioning,and paclitaxel drug-eluting balloon angioplasty was performed without any stents,achieving favorable outcomes.CONCLUSION A PPCI without stents may be a viable treatment strategy for select patients with STEMI,and further research is warranted.

关 键 词：STsegment elevation myocardial infarction Recombinant human prourokinase De novo coronary lesion Large vessels Drug-eluting balloon angioplasty Case report 

分 类 号：R542.22[医药卫生—心血管疾病]