PMC9210072_01
Electrocardiogram demonstrating sinus tachycardia.
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A 12-lead electrocardiogram (EKG) demonstrated sinus tachycardia (Figure 1).
Coronary angiogram (A) showing a thrombus in the proximal left anterior descending artery (blue arrow) and (B) post mechanical thrombectomy.
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Coronary angiography was performed and a thrombus was noted in the proximal left anterior descending artery (LAD), extending from the ostium to just before the first diagonal branch (Figure 2A). Tirofiban was administered, and aspiration thrombectomy was performed, and a repeat angiogram and IVUS were done, which confirmed removal of most of the thrombus with minimal clot burden noted (Figures 2B and 3C).
Intravascular ultrasound of the (A) proximal left anterior descending artery showing intimal flap entry point (red arrow) and intracoronary thrombus, (B) proximal left anterior descending artery distal to the intimal flap entry point showing the extent of the thrombus (yellow asterisks), and (C) proximal left anterior descending artery post mechanical thrombectomy showing a slightly smaller thrombus size.
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It was also noted that there was an intimal flap at the proximal part of the LAD just a few millimeters distal to the ostium of the vessel (Figures 3A and 3B). Tirofiban was administered, and aspiration thrombectomy was performed, and a repeat angiogram and IVUS were done, which confirmed removal of most of the thrombus with minimal clot burden noted (Figures 2B and 3C).