AUTHOR=Shen Mingzhi , Liao Yichao , Wang Jian , Zhou Xinger , Guo Yuting , Nong Yingqiao , Guo Yi , Lu Haihui , Jin Rongjie , Wang Jihang , Fu Zhenhong , Li Dongyun , Zhao Shihao , Tian Jinwen 

TITLE=Intracoronary artery retrograde thrombolysis combined with percutaneous coronary interventions for ST-segment elevation myocardial infarction complicated with diabetes mellitus: A case report and literature review

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=9

YEAR=2022

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2022.962127

DOI=10.3389/fcvm.2022.962127

ISSN=2297-055X

ABSTRACT=<sec><title>Background</title><p>The management of a large thrombus burden in patients with acute myocardial infarction and diabetes is still a worldwide problem.</p></sec><sec><title>Case presentation</title><p>A 74-year-old Chinese woman presented with ST-segment elevation myocardial infarction (STEMI) complicated with diabetes mellitus and hypertension. Angiography revealed massive thrombus formation in the mid-segment of the right coronary artery leading to vascular occlusion. The sheared balloon was placed far from the occlusion segment and urokinase (100,000 u) was administered for intracoronary artery retrograde thrombolysis, and thrombolysis in myocardial infarction (TIMI) grade 3 blood flow was restored within 7 min. At last, one stent was accurately implanted into the culprit’s vessel. No-reflow, coronary slow flow, and reperfusion arrhythmia were not observed during this process.</p></sec><sec><title>Conclusion</title><p>Intracoronary artery retrograde thrombolysis (ICART) can be effectively and safely used in patients with STEMI along with diabetes mellitus and hypertension, even if the myocardial infarction exceeds 12 h (REST or named ICART <ext-link ext-link-type="uri" xlink:href="https://clinicaltrials.gov" xmlns:xlink="http://www.w3.org/1999/xlink">ClinicalTrials.gov</ext-link> number, ChiCTR1900023849).</p></sec>