PMC3279691_01
At the first angiogram all large branches of the left coronary artery were occluded. Right anterior oblique (RAO) projection.
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The left main stem and the most proximal parts of the left anterior descending branch (LAD), an intermediate branch, and the circumflex branch were all angiographically normal, but there was no contrast flow at all to the more distal parts of any of these three branches (Figure 1).
The first repeat angiogram twelve days after infarction showed an open circumflex artery, but the LAD was occluded distally with a wall adherent thrombus proximal to the occlusion. Right anterior oblique (RAO) projection.
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fig2
Twelve days after admission, before the colectomy, the circumflex artery was open without any stenosis, but the left anterior descending artery was occluded in its mid portion with a partly wall-adherent thrombus proximal to the occlusion, and the intermediate branch was subtotally occluded (Figure 2).
Three months after the infarction, only minor irregularities in the distal part of the LAD remained. Left anterior oblique (LAO) projection.
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However, in the meantime, she had become free of her chest discomfort, and all left coronary artery branches were now open with only minor irregularities remaining (Figure 3). 