{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T16:19:58Z","timestamp":1787761198819,"version":"build-2784847793"},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Intracoronary thrombus is common in patients with ST-elevation myocardial infarction (STEMI). Percutaneous coronary intervention (PCI) is the treatment of choice for these patients. Intracoronary thrombus is still a challenge during PCI in STEMI, even with dual antiplatelets, glycoprotein IIb\/IIIa inhibitor, and anticoagulation. Intracoronary thrombus can cause distal or nonculprit vessel embolization and no-reflow state. No reflow results in large infarct size, adverse left ventricular remodeling, arrhythmias, and death. Recently, catheter-directed intracoronary thrombolysis (ICT) is gaining acceptance in patients with no-reflow due to a large thrombus burden.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim:<\/jats:title>\n                    <jats:p>Evaluation of catheter-directed ICT in patients with acute STEMI who develop no reflow due to large thrombus burden during PCI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods and Results:<\/jats:title>\n                    <jats:p>This was a retrospective observational study conducted after approval of the institutional ethics committee in a tertiary care hospital of north India from April 15, 2021 to April 14, 2022, included 1020 adult patients who had undergone coronary evaluation. 37.25% patients had PCI, among these 10% had PCI for acute STEMI. Thrombolysis in myocardial infarction (TIMI) Grade 5 in 79.17% and Grade 4 in 20.83%. ICT was done with low-dose tenecteplase (15 \u00b1 5 mg). The TIMI flow III in 91.67% and II in 8.33% of patients was achieved after intracoronary thrombolysis. Major risk factor was tobacco smoking in 41.67%, and the major complication was left ventricular failure in 33.33%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Catheter-directed ICT is safe and effective in reducing thrombus burden, thus improving myocardial reperfusion in STEMI. This condition has a grave prognosis and can lead to adverse cardiac outcomes. There are many drugs that have been tried to manage no reflow. The use of ICT to treat no-reflow state can be life saving with minimal systemic side effects.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ijabmr.ijabmr_407_22","type":"journal-article","created":{"date-parts":[[2022,12,21]],"date-time":"2022-12-21T01:30:37Z","timestamp":1671586237000},"page":"260-264","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Management of no Reflow during Percutaneous Transcoronary Angioplasty with Catheter-Directed Intracoronary Thrombolysis: A Retrospective Observational Study"],"prefix":"10.4103","volume":"12","author":[{"given":"Rakendra","family":"Singh","sequence":"first","affiliation":[{"name":"Department of Medicine, Adesh Institute of Medical Sciences and Research Bhatinda, Punjab, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjeev Kumar","family":"Singla","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care, Adesh Institute of Medical Sciences and Research Bhatinda, Punjab, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ankush","family":"Singla","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care, Adesh Institute of Medical Sciences and Research Bhatinda, Punjab, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Surbhi","family":"Manchanda","sequence":"additional","affiliation":[{"name":"Department of Medicine, Adesh Institute of Medical Sciences and Research Bhatinda, Punjab, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manjot","family":"Kaur","sequence":"additional","affiliation":[{"name":"Department of Radiology, Adesh Institute of Medical Sciences and Research Bhatinda, Punjab, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2022,12,19]]},"reference":[{"key":"R1-20240902","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1016\/j.jacc.2007.04.059","article-title":"Angiographic stent thrombosis after routine use of drug-eluting stents in ST-segment elevation myocardial infarction:The importance of thrombus burden","volume":"50","author":"Sianos","year":"2007","journal-title":"J Am Coll Cardiol"},{"key":"R2-20240902","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1111\/j.1540-8183.2009.00464.x","article-title":"Angiographic quantification of thrombus in ST-elevation acute myocardial infarction presenting with an occluded infarct-related artery and its relationship with results of percutaneous intervention","volume":"22","author":"Miranda-Guardiola","year":"2009","journal-title":"J Interv Cardiol"},{"key":"R3-20240902","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1097\/MCA.0000000000000743","article-title":"Effects of different strategies on high thrombus burden in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary catheterization","volume":"30","author":"Xiao","year":"2019","journal-title":"Coron Artery Dis"},{"key":"R4-20240902","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1016\/S0002-9149(02)03233-2","article-title":"Predicting angiographic distal embolization following percutaneous coronary intervention in patients with acute myocardial infarction","volume":"91","author":"Fukuda","year":"2003","journal-title":"Am J Cardiol"},{"key":"R5-20240902","doi-asserted-by":"crossref","first-page":"1354","DOI":"10.1161\/01.CIR.93.7.1354","article-title":"Coronary plaque erosion without rupture into a lipid core. 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