PMC3809984_01
An ECG of the patient (on arrival to the emergency) showing ST-segment elevation in all precordial leads (V1 through V6), aVL and I, with ST depression in inferior leads, indicating extensive anterior MI.
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Electrocardiograph ECG showed extensive antero-lateral ST-segment elevation myocardial infarction (Figure 1).
(A) LAD injection showing total occlusion of proximal part by a fresh thrombus (arrow). (B) LAD injection after passing the BMW wire. (C) RCA injection showing total occlusion of distal part by a fresh thrombus (arrow). (D) RCA injection after passing the BMW wire.
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The patient's coronary angiography showed total occlusion by a fresh thrombus to both proximal LAD (Figure 2A) and distal RCA (Figure 2C). TIMI 3 flow immediately after passing it (Figure 2B). This was followed by deployment of a bare metal stent (BMS), with good angiographic results (Figure 3A). TIMI 3 flow was established (Figure 2D). This was followed by balloon dilatation, then a BMS was deployed, with TIMI 3 flow post-deployment (Figure 3B).
(A) LAD injection post-stenting showing a diffusely diseased LAD with TIMI III flow. The stent is illustrated by the arrow. (B) RCA injection post-stenting showing adequate TIMI III flow. The stent is illustrated by the arrow.
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TIMI 3 flow immediately after passing it (Figure 2B). This was followed by deployment of a bare metal stent (BMS), with good angiographic results (Figure 3A). TIMI 3 flow was established (Figure 2D). This was followed by balloon dilatation, then a BMS was deployed, with TIMI 3 flow post-deployment (Figure 3B).