Low Dose of Intracoronary Tenecteplase in High Thrombus Burden in Primary Percutaneous Coronary Intervention – A Case report

Primary percutaneous coronary intervention (PPCI) has emerged as the current standard of care for ST elevation myocardial infarction (STEMI) in achieving reperfusion of injured artery. Most of the STEMI can achieve reperfusion by using stenting, however, condition may not be the same when there is presence of massive intracoronary thrombus in PPCI. It remains challenging and is a strong predictor of adverse outcome. Thus, there is a need for further appropriate strategy to ensure coronary reperfusion in order to reduce morbidity and mortality. We hereby report a case with high thrombus burden in PPCI, after failed manual aspiration thrombectomy, which is successfully treated with low dose of intracoronary thrombolysis. Re-look angiogram showed complete resolution of thrombus in dominant right coronary artery (RCA) compared to previous angiogram.