The Official Journal of EuroPCR and the European Association of Percutaneous Coronary Interventions (EAPCI)

How should i treat?

How should I treat a massive left main coronary artery thrombosis in a 49-year-old woman in the context of cardiogenic shock?

EuroIntervention 2016;11:e1687-e1690 published online e-edition April 2016. DOI: 10.4244/EIJV11I14A321

1. GVM Care & Research, Anthea Hospital, Bari, Italy; 2. Cardiovascular Department, A.O. Papa Giovanni XXIII, Bergamo, Italy; 3. Department of Cardiology, Angiology and Intensive Care Medicine, University Heart Centre Lübeck, University Hospital of Schles


BACKGROUND: A 49-year-old female was referred to our cathlab for an extensive anterior STEMI complicated by cardiogenic shock.

INVESTIGATION: Coronary angiography.

DIAGNOSIS: Left coronary angiography revealed occlusion of the left main stem with evidence of massive intracoronary thrombus.

MANAGEMENT: Manual thrombectomy followed by super-selective adenosine injection by thrombus aspiration catheter combined with an intracoronary bolus of abciximab was performed. A drug-eluting stent was implanted in the left main and proximal left descending artery.

KEYWORDS: cardiogenic shock, crushed ticagrelor, hyperhomocysteinaemia, intra-aortic balloon pumping, STEMI


A previously healthy 49...

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