PMC5821975_01
Admission electrocardiogram.
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Admission ECG showed sinus rhythm with both anterior and inferior ST-segment elevation (Figure 1).
Coronary angiography. Marked ectasia and proximal occlusion of right coronary artery (a) and left anterior descending coronary artery (b). After initial ballon angioplasty, both vessels showed extensive thrombus burden and flow restriction (c and d).
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Surprisingly, thrombotic occlusions of both proximal RCA (Figure 2(a)) and mid LAD (Figure 2(b)) were disclosed. Manual thrombus aspiration with Export catheter was performed, and such approach allowed much better thrombus clearance and vessel delineation (Figure 2(d)). Manual aspiration also allowed better vessel delineation (Figure 2(c)).
Final angiographic result. Both right coronary artery (a) and left anterior descending coronary artery (b) showing good angiographic result, with TIMI 3 flow and no residual stenoses.
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Angiographic success (Figure 3) was achieved, and IIb/IIIa glycoprotein inhibitor was maintained for 12 hours in continuous infusion.