Combination of a high bolus dose of tirofiban with half-dose thrombolytics for the treatment of subacute stent thrombosis

Acute stent thrombosis is rare and it is usually related to complications during the procedure. Subacute thrombosis is far more common and is associated with a high incidence of acute myocardial infarction and death. Restoration of flow by thrombolysis, emergency bypass surgery or emergency percutaneous transluminal coronary angioplasty (PTCA) has had only limited success with respect to myocardial salvage. We report the case of a patient who suffered from recurrent subacute stent thrombosis, in whom administration of tirofiban at high-dose bolus in association with a half dose of recombinant tissue plasminogen activator succeeded in restoring normal myocardial flow and stable clinical condition.