Thrombectomy using aspiration catheter- An effective first line approach for resistant thrombi in patient of acute myocardial infarction

Acute myocardial infarction is caused by the rupture or erosion of an atherosclerotic plaque, initiating intraluminal thrombosis resulting in partial or complete occlusion of a coronary artery. Primary percutaneous coronary intervention (PCI) is the preferred treatment and is effective in opening the infarct-related artery. These results can be further improved with thrombus aspiration which reduces stent thrombosis and improves myocardial blush. In acute presentation, there is a high load of thrombus in the infarctrelated artery and stent placement in such a case increases the chances of the thrombus shifting both proximally and distally in the microvasculature. In such patient, deferred stenting along with the attempt of thrombus aspiration has the potential for complete thrombus removal with improvement in TIMI flow which eliminates the need of stenting. Here, we present an interesting case report pertaining to the feasibility of multiple thrombus aspiration attempts (>25) as first approach in young patient (Male/32 years/no comorbidities) with late presentation of STEMI and a large resistant thrombus load on an angiogram. We also re-assessed the need of stenting after 5 days of thrombus aspiration attempt along with continued anticoagulation from the first contact with patient.

Study Of Incidence, Occurrence, Origin, And Histological Types Of Eyelid Tumors At Tertiary Care Hospital In Ahmedabad

Background: The aim of the study was to know occurrence, incidence, and various histopathological variants of eyelid tumors.It is incidence with respect to age and to analyse the distribution of tumors in various age group at new civil Hospital, Asarwa,Ahmedabad.Materials and Methods: A total of 100 cases of eyelid tumors were analyzed retrospectively in a period from May 2008to November 2010. Cases were studied in detail about general information of the patient including age and sex and grossexamination and histological features.Result: Of 100 tumors, 56 (56%) were benign and 44 (44%) were malignant. Of 56 benign lesions, 41 were in pediatric agegroup (<18 years) and 15 were in adult patients (>18 years). The common benign lesion seen was nevi (21%) followed bysquamous papilloma (12%). The common malignant lesion seen was meibomian gland carcinoma (22%) followed by basal cellcarcinoma (12%). Distribution of tumor based on origin on descending order was epithelial origin (33%), adnexal origin (23%),melanocytic origin (22%), and mesenchymal origin (22%).Conclusion: As eyelid skin is the thinnest and most sensitive skin in our body, it is often the first area in body to show changesoccur from sun damage and aging. Skin cancer of the eyelids is relatively common and of several types. Overall, the incidenceof benign tumors (56%) was more than malignant tumors (44%) in the present study. Benign tumors were more common inadolescent and young adults. Mean age of benign tumors was 33.83 years. Malignant tumors were more common in elderly. Meanage of malignant tumors was 61.40 years. Overall, sex distribution of benign and malignant tumors is equal in both the sexes.