Work

Stent-Free Excimer Laser Atherectomy in AMI With Aplastic Anemia and Thrombocytopenia

Year: 2025

Type: article

Abstract: BACKGROUND: Acute myocardial infarction (AMI) complicated by aplastic anemia with severe thrombocytopenia presents a therapeutic dilemma because of conflicting bleeding and thrombotic risks. CASE SUMMARY: /L) and ST-segment elevation myocardial infarction underwent excimer laser coronary atherectomy (ELCA) combined with a stent-free strategy. Coronary angiography revealed multivessel disease with total right coronary artery occlusion. ELCA reduced thrombus burden, restored TIMI flow grade 3, and avoided the need for dual antiplatelet therapy. Follow-up confirmed sustained patency and no bleeding complications. DISCUSSION: This case highlights the efficacy of ELCA in resolving thrombotic burden while circumventing dual antiplatelet therapy and stent-related risks, addressing a literature gap in managing AMI with severe thrombocytopenia. TAKE-HOME MESSAGES: ELCA with a stent-free approach safely restores coronary flow in patients with thrombocytopenic AMI, balancing thrombus resolution and bleeding risks. This strategy offers a paradigm for high-risk cases where conventional therapies are contraindicated.

Source: JACC Case Reports

DOI: 10.1016/j.jaccas.2025.104658

Authors: Yuehua Ma, Qinping Zhang, Wei Wang, Lei Gao

Institutions: Xinxiang Central Hospital, Chinese People's Liberation Army, Chinese PLA General Hospital

Language: English

Topic: Coronary Interventions and Diagnostics

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $850