{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T15:49:23Z","timestamp":1753890563982,"version":"3.41.2"},"reference-count":20,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,8,4]],"date-time":"2022-08-04T00:00:00Z","timestamp":1659571200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>How to deal with large thrombus burdens of culprit\u2019s blood vessel remains a great challenge in the treatment of acute myocardial infarction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case presentation<\/jats:title><jats:p>A 32-year-old Chinese man was diagnosed with ST-segment elevation myocardial infarction (STEMI). Coronary angiography revealed that the distal end of a tortuous left circumflex was completely occluded by a large amount of thrombus. Cutted balloon-directed intracoronary artery retrograde thrombolysis (ICART) with urokinase led to the restoration of coronary blood flow. Because there was no obvious plaque rupture or artery stenosis in the coronary artery, it was only dilated, and no stent was implanted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Cutted balloon-directed ICART can be performed effectively and safely in some STEMI patients with tortuous coronary vessels and large thrombus. (REST or named ICART <jats:ext-link>ClinicalTrials.gov<\/jats:ext-link> number, ChiCTR1900023849).<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcvm.2022.934489","type":"journal-article","created":{"date-parts":[[2022,8,4]],"date-time":"2022-08-04T04:41:15Z","timestamp":1659588075000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Intracoronary artery retrograde thrombolysis for ST-segment elevation myocardial infarction with a tortuous coronary artery: A case report and review of the literature"],"prefix":"10.3389","volume":"9","author":[{"given":"Mingzhi","family":"Shen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haihui","family":"Lu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yichao","family":"Liao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jian","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi","family":"Guo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xinger","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yingqiao","family":"Nong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhenhong","family":"Fu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jihang","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuting","family":"Guo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shihao","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li","family":"Fan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jinwen","family":"Tian","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,8,4]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"2383","DOI":"10.1016\/j.jacc.2009.12.054","article-title":"5-year prognostic value of no-reflow phenomenon after percutaneous coronary intervention in patients with acute myocardial infarction.","volume":"55","author":"Ndrepepa","year":"2010","journal-title":"J Am Coll Cardiol."},{"key":"B2","doi-asserted-by":"publisher","first-page":"1449","DOI":"10.1016\/j.amjcard.2014.01.423","article-title":"Thrombus burden and myocardial damage during primary percutaneous coronary intervention.","volume":"113","author":"Napodano","year":"2014","journal-title":"Am J Cardiol."},{"key":"B3","doi-asserted-by":"publisher","first-page":"695","DOI":"10.1016\/j.jcin.2010.05.004","article-title":"Prevention and treatment of microvascular obstruction-related myocardial injury and coronary no-reflow following percutaneous coronary intervention: a systematic approach.","volume":"3","author":"Jaffe","year":"2010","journal-title":"JACC Cardiovasc Interv."},{"key":"B4","doi-asserted-by":"publisher","first-page":"1389","DOI":"10.1056\/NEJMoa1415098","article-title":"Randomized trial of primary PCI with or without routine manual thrombectomy.","volume":"372","author":"Jolly","year":"2015","journal-title":"N Engl J Med."},{"key":"B5","doi-asserted-by":"publisher","first-page":"1042","DOI":"10.1016\/j.ahj.2010.08.040","article-title":"Thrombus aspiration in ST-elevation myocardial infarction in Scandinavia (TASTE trial). 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