562
4356558020012657115
www.iakardiologie.cz3408040010765133201214233274312354380428447495515563613632675690730769
/27308040010732
Interv280780400107196793136162206
Akut3033804001075391139167
Kardiol.3220804001074587114162180228248264
2024;23(1):43-493504804001074487128168182227271293333350365408449476523565
/41148040010731
INTERVENČNÍ4191804001071978123168215263308366420478499
A47128040010752
AKUTNÍ4786804001075399158202263284
KARDIOLOGIE50918040010745103150211232295337397456477521
KAZUISTIKA4286200012665137200272306365424456524597
/4904200012632
CASE4957200012660131190248
REPORT5227200012662120184260325384
The276236001063071103
role288136001063374105137
of303436001063869
intracoronary31193600106155689125166200238274315357397432468
thrombolysisin360336001063071107147201237278310342375392424441482
thrombus-laden410136001063071106147201237278310338368410450482523
coronary464036001063271107148190229265301
artery:495736001063873105137173209223
a5194360010638
case524836001063274108139
report540336001063366101142178209
The3409200298132270396
role784920029891229294420
of12539200298138219
intracoronary15209200298662062913835066137498399771116124213311461
thrombolysis302992002988923032045766280594210081132123312981401
in3401180029866205
thrombus-laden59411800298882293194566618049431046112311901316145815831724
coronary236611800298109245335472611737827956
artery:337111800298127216307433524653715
a413411800298127
case431011800298108234336462
report48201180029891217360499589679
I3401580013731
Gde3941580013775141200
Rurus6161580013765129171235283
Suryawan1,9221580013759123165225283366423488140315900803614371580013729
Rizal1488158001376596148207238
Muhammad2,17481580013793158222280375470528594234115900803623791580013729
Fita2430158001375886127186
Triastuti226381580013760951251832312723363774083044159008036
1Division34017400783344371174001337399152177220245305366
of760174001336092
Interventional875174001332687122176212267321382417442502563615640
Cardiology,15391740013363116152213238298324384446498515
Department20781740013373129191244279318410465526561
of2662174001336092
Cardiology27771740013364117152214239299325385447499
and32991740013353114176
Vascular34981740013361111154203263288340376
Medicine,38971740013388144206232280305365420442
Faculty43621740013354102151211236272326
of4711174001336192
Medicine,48271740013388144206231280305365420442
Universitas3711890013371131156209262298342367403456499
Airlangga,893189001336792127153205266327388441463
Dr.13801890013373109127
Soetomo15301890013354115170206265357417
Academic19701890013368116169231285377402451
General24441890013371127188243279332357
Hospital,28241890013372133175237263299352377399
Indonesia3247189001332686148208269324367392444
2Department340204007833473732040013373129191244280319410465526561
of957204001336192
Cardiology10722040013364117152214239299325385447499
and15942040013353114176
Vascular17932040013361111154203263288340376
Medicine,21922040013388144206231280305365420442
Faculty26572040013353102151210236272326
of3006204001336192
Medicine,31222040013388144206231280305365420441
Universitas35872040013371131156208262298342366402456498
Airlangga,4109204001336792127153205265327388440463
Dr.45952040013374110127
Soetomo47462040013354114170206265357417
Academic3732190013367115168230285376402450
General8472190013371127188243278331357
Hospital,12272190013372132175237262298351377399
Indonesia1649219001332687149209270325368392445
Introduction:340269001232788126164224286346394434462522583608
Large9922700012149101137196249
intracoronary1285270001212483118153205252309345403462513548602
thrombus1931270001213492127185273333392434
in2409270001212483
patients25362700012158110145171224283318362
presenting2942270001215894147189243302337362421480
with34662700012176102138197
ST37062700012151105
elevation340284001215074124172220253276331387
myocardial7472840012183129183228277310366389437460
infarction1227284001212479108157189233269292347403
(STEMI)1650284001212875125175255279307
can1977284001214593148
cause2145284001214594149188238
distal2403284001215780119153202225
embolization,26482840012150134191246270293336386418441496552573
the3241284001213388139
no-reflow34002840012155110143177227257283338411
phenomenon,3402980012158115166223279365416473529586607
and9772980012148105163
stent1169298001214075125182215
thrombosis.1413298001213490123179264322379419442482504
Approximately19462980012162120178212268314339423472505556580629
10%26042980012152100181
of2814298001215686
patients29292980012158108141164216273306347
undergoing33052980012156113170222255312368393449506
primary340312001215994119205256290343
percutaneous7183120012159112147194251286338396449507565606
coronary13593120012146103138195253304338391
intervention1785312001212482116168203257308366401426483542
(PCI)2362312001212984144169198
have25953120012157108157208
distal2838312001215883124160212237
embolization31103120012151138198256282307352404438463521579
of3724312001215788
thrombus,340326001213387119172255310365403424
causing781326001214492145184206260315
coronary1114326001214497129182237284316365
microvascular14973260012182105149180234280328366410464487534566
obstruction20803260012154110149182214268312347369423478
and25753260012148102158
reduced2750326001213281137191235284340
myocardial31073260012182127180225273305360382429452
tissue357632600121335594132185235
perfusion.3403400012157108141173229268291346402423
This7893400012150106130169
can984340001214594149
lead1159340001212474122179
to1364340001213387
ongoing14783400012155110167222245300356
ischemia,1861340001212362107162213296320367388
a22763400012148
larger2350340001212472105160211243
infarct2620340001212378107156189233268
size,2915340001213962105155175
and31163400012148104160
a33033400012148
significant3377340001214063119174197226253297346401434
increase340354001212378122154203251289339
in697354001212377
30-day7923540012151101135193240285
mortality,10953540012182137169205253276299331380396
regardless1508354001213382138186218273296346385423
of1949354001215483
successful2049354001214093138181229268307337392415
PCI24813540012153110133
with2631354001217396129183
normal28323540012155109142225272295
epicardial31453540012149106129173221253309331379402
vessel3564354001214896135174224247
flow.340368001212956111184201
Case3403810012361114158212
Presentation:586381001235895149194248309345400436463523583607
A12273820012163
51-year-old13253820012153102131180232282317347407433492
Asian18523820012163106130181239
male21253820012186137162215
presented2375382001215893145187240298333384444
with28543820012176102137194
STEMI.30833820012151104156240266289
Coronary34073820012160116151208266317351404
angiography3403960012150107166190248307341392451509557
revealed928396001213486135187237262314374
a13333960012150
large1414396001212474109167219
thrombus1664396001213492126183270329387428
totally2123396001213490125176201225275
occluding24293960012157104150174231291315373431
the2891396001213492145
proximal3067396001215893150197222309359384
portion34823960012158117151189213271329
of340410001215686
the456410001213490142
right628410001213358115172206
coronary8634100012146101135191249298332384
artery1276410001214983120171205257
(RCA).1562410001212984143208236255
Catheter-directed18474100012159109143199251286337371400460484518569616653704763
intracoronary2639410001212481114148198244299333390447496530582
thrombolysis3250410001213491124181266325382407456497521561
with3404240012175100135192
streptokinase561424001214176110162221255311360386443493533586
was11764240012176126166
performed13724240012159111146179236270357409468
after1870424001214980117169203
multiple21024240012186143167201226284309361
attempts2493424001214983120171257316350392
at2915424001215083
manual30284240012186135193249299323
aspiration3381424001215090149173207257291315372430
thrombectomy340438001213388121175259316367412448502585631
(MAT)9924380012128107168211243
and12564380012148103160
balloon14374380012157105129152207263318
angioplasty17764380012149104160183238295319367406440490
had22874380012156104160
failed2468438001213078102125175232
to2721438001213488
achieve2830438001214893148171221269318
coronary3169438001214598131186241289322372
blood3562438001215781136192249
flow340452001212956111184
recovery.544452001213383128182229278311361378
After942452001216290126176209
successful1171452001214094139183232271310341396420
stenting,1611452001214074123179211234289345366
a19984520012148
diffuse2066452001215780109142198237287
residual2374452001213382122145201256304328
thrombus2722452001213388121175259316371410
remained3153452001213382166214237292343400
in3574452001212378
the3673452001213388138
RCA.3404660012154111174196
Evaluation554466001214996144168222270302325380435
angiography10074660012148103159182237293326374430486531
of1556466001215584
the1657466001213388138
RCA18134660012154111174
performed20044660012157108141173227260344394451
four2473466001212984139171
days26624660012156104149188
later2868466001212471104153185
showed3071466001214095149222271328
complete3417466001214598181238262312345394
thrombus340480001213388121175259316371410
dissolution770480001215680119158213237292325348403459
with1249480001217397130185
thrombolysis1454480001213388120175259315371395443482505544
in2018480001212379
myocardial21164800012184129184229278310366390437461
infarction2597480001212378107156189233268291346402
(TIMI)3019480001212881105185210237
grade3276480001215688137193244
335404800012151
flow.3611480001212955110183201
Discussion:340493001237098141189248291334361420480504
While8744940012187145170194247
there1151494001213491144178230
is1411494001212465
no15064940012157114
gold-standard16504940012158115140199232274309360418477527561619
therapy2299494001213492144178229288336
to2665494001213490
deal27854940012158111161186
with30014940012175100135192
intracoronary3223494001212482116150200247303337394452502536588
thrombus,340508001213387119173255311366404425
there782508001213387137169218
are1017508001214880129
combinations1163508001214598180236259314361393415469524563
of1743508001215483
both18435080012156111144198
pharmacological20585080012156112159191273321365418441496551574618666689
and27645080012148102158
mechanical29395080012183133178232279334356400448471
therapies3427508001213388137169217273296346384
that340522001213388136169
can531522001214594149
be7035220012157108
utilized.833522001215588111135158200250308329
MAT11845220012181142185
should1392522001214095150205229285
not17005220012155110143
be18665220012157108
used1996522001215595145202
routinely2221522001213387143176199254304328376
in2619522001212479
STEMI,2721522001214999149229254275
but30185220012157113146
may31865220012184132178
be33865220012157108
helpful35175220012155106130186216271295
in340536001212479
selected448536001214091115166212248297355
cases.832536001214594133184224246
Catheter-directed11065360012159108141196247281331364392452475508558604640690747
intracoronary1882536001212479112145194239293326382438486519570
thrombolysis2481536001213388121176261318374398446486509549
can3059536001214594150
be32375360012157109
a33745360012149
safe3452536001213989118169
and36505360012148104161
effective340550001215080112163208244267315364
alternative727550001214872105154187243291323346394443
reperfusion1193550001213383140191224256312351374429485
strategy1700550001214074106155187237293341
when20645500012174129180235
MAT23225500012181142185
alone2530550001214872127183233
fails2786550001212978101124163
to2972550001213387
achieve3082550001214893148171221269318
sufficient3423550001213994123156182227250300355388
coronary340564001214599131186242290322373
blood734564001215781136192249
flow1004564001212956111184
in1209564001212378
the1309564001213388138
thrombotic1468564001213489121176259316372405428472
infarct-related1962564001212378107156189233268296330380404452484533591
artery2574564001214881116166199249
(IRA).2844564001212951105168196214
Conclusion:3405780012160116174221246303344368426484505
The8775780012151110162
management10715780012186136194244302355442495553587
of1689578001215788
intracoronary1808578001212482116150201248304339396454504538591
thrombus2431578001213491125182269328386427
during28905780012158115149174232291
PCI32125780012155115140
remains3383578001213486173223248305346
a37615780012150
therapeutic340592001213388139172220277328383416439484
challenge,8495920012145100148172195245301357407427
and13015920012149104161
an14875920012148103
aggressive,16165920012148104160193242282321344392441461
case-by-case,2103592001214493132183216274321352399448487538557
tailored2686592001213382105128183216266323
approach30355920012148105162195249298343398
can3458592001214594149
lead3632592001212474122179
to340606001213387
improved4486060012124107164196251298347405
outcomes.8746060012155110143187241324375414435
Key3406220012462114166
words:5336220012477135174235280306
intracoronary867623001212479112145194240294327383439487520571
streptokinase,1467623001214074107158215249303351377432481521572592
manual20876230012185133189244293317
aspiration2432623001214989146170203252285308364420
thrombectomy2881623001213389122177261319370417452507592638
(MAT),35476230012129108171214246265
intracoronary340637001212379111143192237291323378434482514565
thrombus,931637001213489121176259316371411432
primary1390637001215689113196244277327
percutaneous17446370012157108141185240273322377427483539578
coronary2349637001214498131186241289322372
intervention2748637001212379111160193244293349381404460515
(PCI),3290637001212881139162189208
ST-elevation35246370012150100127180204254340651001214897129152207263
myocardial6246510012183129183229277310366389437461
infarction1106651001212378107156189233268291346402
(STEMI).1529651001212975126176256280307326
Role3406780012459117146199
intrakoronární559678001242887124163216270327366424483537575634662
trombolýzy1241678001243776135221282340369421470525
v17866780012453
případě1859678001246099126187240300353
trombotizované2233678001243676134221281340377405453512564617676729
koronární29826780012454112150208268321360418446
tepny:3449678001243690150210261287
kazuistika3406920012454108156215243287324353407461
Úvod:3407090012367119176236259
Velké6287100012156104129176226
intrakoronární883710001212379112146195243297331386443492525582605
tromby1518710001213366122207264312
u18597100012155
pacientů19447100012157107152176227284317372
s23457100012140
infarktem2414710001212480110160193241277327412
myokardu28557100012185131186234285318375430
s33147100012141
elevacemi3384710001215075126175224270319404428
úseku340724001215594145192247
ST6107240012149100
(STEMI)732724001212875125175255280307
mohou10617240012184139195250305
způsobit13887240012143100155194250307330363
distální1774724001215679118152201225280303
embolizaci,20997240012150134190246270293336386431453474
fenomén2595724001212980135190274324380
„no-reflow“2997724001213692147180214264294320375448486
a35057240012148
trombózu35757240012133661202043407380012157112154209
stentu.567738001214074123178211265286
Přibližně871738001215385108165189212254310360
u12497380012155
101322738001215198
%14387380012179
pacientů15357380012157105150173223279311366
podstupujících19197380012156112169209242297354409433456500523568623
primární2560738001215789113196244276332355
perkutánní29337380012157108141188243276325380435458
koronární34097380012147101134188244292324380403
intervenci340752001212379111160193244293349394417
(PCI)775752001212880138161188
dochází9817520012157112158213260304327
k13267520012147
distální1391752001215780119153201225280303
embolizaci17127520012150134190246270293336386430453
trombu,2183752001213366120204261316337
což2538752001214598141
způsobuje26967520012143100156195250307362386436
mikrovaskulární31507520012184107153187242289338377423479502550582638661
obstrukci3407660012155112152186218274321364388
koronárních7567660012147101134188244292325381404449504
tepen1288766001213383140191247
a15637660012149
snížení1640766001214095118161211267290
perfuze19597660012157108141173229272322
myokardiální23107660012183129183231280313369392440464519542
tkáně.2880766001213380129185235255
To3163766001215099
může32907660012183138181231
mít35497660012184107140
za3718766001214393
DECLARATIONS:4068269008648871301662142563043393604124625014569269008514
Declaration406828300874987120141179207245272292334376
of445828300874166
originality:45382830087406888131151193231252272299338358
The406829400853473109
manuscript418829400855891130168195227249266306329
is452829400851644
original45832940085386178117133172205222
and481629400853472112
has49392940085387299
not50502940085387699
been516129400853975110149
published532129400854078118135151178217252292
or406830500853862
submitted414530500852867108167184208234269310
elsewhere.44703050085355381117169209245269305320
Ethical406831900873764107127160198219
principles43013190087427090132165185229249288319
compliance:463531900873172134177198218256298331369388
The406833000853678116
authors420533000853475100142183208238
attest44643300085356087124154179
that466433000852465101126
their481133000852465103121146
study49783300085295596138173
was517333000855389118
approved531333000853477119144185220257300
by406834100854073
the41583410085236399
local42743410085165689124141
Ethical44323410085345898115147182199
Committee464834100854179139198215239265300337
and500134100853474114
is513234100851745
in519434100851656
compliance526634100853270130170188205239279311347
with40683520085537298139
human423535200854082143180222
studies44853520085285596139157195226
and473935200853476119
animal48863520085347695157193212
welfare512635200855391110133170195233
regulations53873520085246110414616420140683630085234080120148
of423636300853859
the43153630085236399
authors’44343630085347397136176200229244
institutions46983630085175684109126150189214231270310338
as505636300853462
well513836300855187105122
as528036300853362
with53613630085526994133
the55143630085236399
World406837400856099124142184
Medical427337400855795137154188224242
Association453537400854474104144178196231256273314355
Declaration491137400854785119136172196232257274315356
of528837400853961
Helsinki536937400854785103132150190225244
on406838500853878
Ethical41653850085345898115147182199
Principles43833850085376178117150167207225261290
for46913850085216084
Medical479438500855693134151183218235
Research504838500853874102139173197229268
Involving53353850085165690128146181198238278
Human406839600854685145179219
Subjects430739600853474114132168201227256
adopted458339600853474114155179215256
by485939600853973
the49523960085236399
18th507139600853669514139600501437
WMA5198396008559116160
General537839600854582122158182217235
Assembly406840700854475105143204247266302
in439340700851758
Helsinki,447440700854785104134152193228248264
Finland,47614070085355394113149190232249
in503340700851758
June511540700852668109147
1964,528540700853771110150166
with54754070085537197138
subsequent406841800852867107136172213252288328352
amendments,443741800853493129169210269305345369398414
as486841800853462
well494841800855287105122
as508841800853362
with51674180085526993133
the53184180085236299
ICMJE543441800851759116143179
Recommendations406842900853977112153216278317359402439465483525568598
for46984290085216389
the481842900852466105
Conduct,495442900854283126169210245272290
Reporting,527642900853877120163189217235277320337
Editing,40684400085347491115132172212227
and430844000853373113
Publication443444000853776117134151183218242259298338
of478544000853859
Scholarly485744000853467106146163198221239273
Work514244000856097121155
in531044000851655
Medical537844000855693134151183218235
Journals,406845100852666105129169204221250265
updated435345100853979121155179214256
in462845100851756
December470445100854784116152211252289313
2018,503645100853673107140156
including52124510085165688105145185203242283
patient55144510085407540684620085234076116140
consent422246200853270110138175215238
where447546200855191128151187
appropriate.467746200853474115139178219243260295319354369
Conflict406847600874282125150171191224252
of433447600874066
interest44144760087196188126154192224251
and467947600873779122
financial48164760087234587125167200221259279
disclosures:51104760087416293126147189220262290328360379
None.406848700854686126162177
Funding/Support:406850000873777120163183225267291330371415458500528556575
None.406851200854686126162177
Cit.4068714008541588297
zkr:41807140085306489105
Interv43007140085165680115139176
Akut449071400854377117141
Kardiol.46457140085387497138155194212227
2024;23(1):43-49488771400853672107142157193230250283299313350385408447483
https://doi.org/10.36290/kar.2024.002406872500853962881291571721982194284725008641811004385725008514547811714345277250086387390130168206244283306343381406421461499536574591630670707
Článek40687360085415892132168202
přijat4285736008539638198133156
redakcí:445673600852359100134168199216231
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10.48037360085367085
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Článek40687470085415892132168202
přijat4285747008539638198133156
k4456747008533
tisku:45047470085234068102141156
20.46757470085367287
2.477774700853652
2024484374700853672107142
I4068766008720
Gde410276600874891130
Rurus424676600874183111153185
Suryawan444576600873879107147185238276319
igde.rurus.s@fk.unair.ac.id40687780085165697133148172212236275304320349402424459476515555589606630643678711727744785