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Histologic evidence of distal coronary thromboembolism. A complication of acute proximal coronary artery thrombolysis therapy.

Distal migration of occluding coronary thrombus during thrombolysis therapy for acute myocardial infarction rarely has been observed angiographically. Necropsy documentation of the final location of embolic fragments in this circumstance has not been reported previously. This report documents multiple occluded intramyocardial vessels with thrombus observed to have showered distally during thrombolysis therapy. Depending on size and number, fragments of dislodging proximal coronary embolus may produce additional myocardial necrosis.