Akut Koroner Sendromda Distal Sol Ana Koroner Arter Tutulumlu Eş Zamanlı Çok Damar Trombozunun Perkütan Tedavisi
Özet
Akut koroner sendromlar çoğunlukla tek bir koroner arterde gelişen trombotik oklüzyon sonucu ortaya çıkmaktadır. Aynı anda birden fazla epikardiyal koroner arterde tromboz gelişmesi ise nadir görülen bir durum olup ciddi morbidite ve mortalite ile ilişkilidir. Özellikle sol ana koroner arterin de dahil olduğu çok damar tromboz vakaları literatürde oldukça sınırlı sayıda bildirilmiştir. Bu olguda distal sol ana koroner arter, sol ön inen arter ve sağ koroner arterde eş zamanlı tromboz saptanan hastanın klinik seyri ve perkütan tedavisi sunulmuştur. Yoğun antitrombotik tedaviye rağmen klinik instabilite gelişmesi üzerine kompleks perkütan koroner girişim uygulanmış ve başarılı sonuç elde edilmiştir.
Acute coronary syndromes most commonly result from thrombotic occlusion in a single coronary artery. The simultaneous development of thrombosis in multiple epicardial coronary arteries, however, is a rare condition associated with significant morbidity and mortality. In particular, cases of multivessel thrombosis involving the left main coronary artery have been reported only rarely in the literature. This case report presents the clinical course and percutaneous treatment of a patient in whom simultaneous thrombosis was detected in the distal left main coronary artery, the left anterior descending artery, and the right coronary artery. Despite intensive antithrombotic therapy, clinical instability developed, leading to the application of a complex percutaneous coronary intervention, which yielded successful results.
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