PMID- 16327953
OWN - NLM
STAT- MEDLINE
DCOM- 20060228
LR  - 20170214
IS  - 0003-3197 (Print)
IS  - 0003-3197 (Linking)
VI  - 56
IP  - 6
DP  - 2005 Nov-Dec
TI  - Intracoronary macrothrombus formation during percutaneous coronary intervention 
      despite optimal activated clotting time using bivalirudin--a case report.
PG  - 761-5
AB  - The occurrence of intracoronary thrombus during percutaneous coronary 
      intervention (PCI) is a well-known complication. It has been estimated that it 
      complicates approximately 6% of all coronary procedures. Patients at highest risk 
      for this complication include those with acute ischemic syndromes or with 
      angiographically apparent thrombus. Since the development of PCI, intravenous 
      unfractionated heparin (UFH) has remained the primary antithrombotic therapy for 
      the prevention of periprocedural ischemic complications. The availability of a 
      rapid "point of care'' test for dose individualization (the activated clotting 
      time [ACT]) has facilitated this process. Other forms of antithrombotic therapies 
      such as direct thrombin inhibitors or low-molecular-weight heparin have been 
      proposed as more effective anticoagulants during PCI. Bivalirudin is a direct 
      thrombin inhibitor proven to decrease post-PCI ischemic complication rate 
      compared with UFH and have a lower vascular complication rate compared with 
      glycoprotein IIb/IIIa receptor antagonists. We herein report a case of acute 
      macrothrombus formation during PCI despite adequate ACT achieved with 
      bivalirudin.
FAU - Tadros, George M
AU  - Tadros GM
AD  - Division of Cardiology, University of Minnesota, Minneapolis, MN, USA.
FAU - Broder, Kevin
AU  - Broder K
FAU - Bachour, Fouad
AU  - Bachour F
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - Angiology
JT  - Angiology
JID - 0203706
RN  - 0 (Anticoagulants)
RN  - 0 (Hirudins)
RN  - 0 (Peptide Fragments)
RN  - 0 (Recombinant Proteins)
RN  - TN9BEX005G (bivalirudin)
SB  - IM
MH  - Angioplasty, Balloon, Coronary/*adverse effects
MH  - Anticoagulants/*therapeutic use
MH  - Coronary Stenosis/diagnostic imaging/*therapy
MH  - Coronary Thrombosis/diagnostic imaging/*etiology/prevention & control
MH  - Hirudins
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Peptide Fragments/*therapeutic use
MH  - Radiography
MH  - Recombinant Proteins/therapeutic use
MH  - Whole Blood Coagulation Time
EDAT- 2005/12/06 09:00
MHDA- 2006/03/01 09:00
CRDT- 2005/12/06 09:00
PHST- 2005/12/06 09:00 [pubmed]
PHST- 2006/03/01 09:00 [medline]
PHST- 2005/12/06 09:00 [entrez]
AID - 10.1177/000331970505600614 [doi]
PST - ppublish
SO  - Angiology. 2005 Nov-Dec;56(6):761-5. doi: 10.1177/000331970505600614.