PubMed · 8099414
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J T Hart. 1993-06-12. Recruitment to randomised controlled trials.. https://doi.org/10.1016/0140-6736(93)90680-f
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These images describe a case of massive left ventricular (LV) thrombosis complicating fatal heart failure in a 61 year-old patient with history of myocardial infarction, apical aneurysm, and no previous evidence of LV thrombosis. Two-dimensional echocardiography showed that the thrombus obliterated 34% of LV volume at end-diastole. Three-dimensional echocardiography allowed higher definition of thrombus architecture and dimensions, revealing obliteration of 40% of LV volume at end-diastole. Careful assessment of thromboembolic risk to guide therapeutic decision making should be considered mandatory in subjects with a large extent of wall asynergy, even in those with no previous evidence of LV thrombosis. Three-dimensional echocardiography may be considered an accurate technique for the characterization of LV thrombi in these patients.
Stent thrombosis (ST) in the era of bare metal stents (BMS) using high-pressure stent deployment and combined anti-platelet therapy is an uncommon but feared complication. There is concern for an elevated risk of stent thrombosis (ST) with drug-eluting stents (DES). We describe a case of simultaneous multivessel drug-eluting stent thrombosis 8 h after deployment of paclitaxel-eluting stents in the right coronary (RCA) and left anterior descending (LAD) arteries.
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