The Effectiveness of Argatroban for Coronary Thrombus during PCI

Abstract

A 58-year-old man was admitted to our hospital because of continual chest pain. The coronary angiography showed severe stenosis of the mid LCX and mid RCA. He was administered dual-antiplatelet therapy and received an infusion of heparin and nitroglycerin. We performed elective percutaneous coronary intervention(PCI) for the mid LCX. Two PES(3.0/28＋3.5/16) were implanted on LCX. After stenting, coronary thrombus appeared suddenly. We performed intravascular ultrasound(IVUS) and recognized much of thrombus and no finding of dissection and stent malapposition. Platelets were not decreased. While plain old balloon angioplasty(POBA) was performed repeatedly under intra-aortic balloon pumping(IABP), coronary thrombus appeared. After argatroban was administered, coronary thrombus disappeared completely. We experienced a case which argatroban was clinically effective in spite of no evidence of heparin-induced thrombocytopenia.