How should I treat?

How should I treat a “swinging” left main thrombosis complicating coronary angioplasty in an obese, diabetic, elderly woman treated with fondaparinux?

EuroIntervention 2012;7:1470-1475. DOI: 10.4244/EIJV7I12A229

Natale Brunetti
Natale Daniele Brunetti*, MD, PhD; Antonio Centola, MD; Erasmo Giulio Campanale, MD; Andrea Cuculo, MD; Antonio Ruggiero, MD; Luigi Ziccardi, MD; Luisa De Gennaro, MD, PhD; Matteo Di Biase, MD
Cardiology Department, University of Foggia, Foggia, Italy

BACKGROUND: A 72-year-old woman with non-ST elevation acute coronary syndrome, treated with fondaparinux.

INVESTIGATION: The patient was treated after recurrent angina with coronary angioplasty and stenting of the left anterior descending artery (LAD). The procedure was complicated by “swinging” left main (LM) thrombosis.

diagnosis: Catheter-related LM thrombosis after fondaparinux administration.

TREATMENT: Urgent LM angioplasty with culotte stenting of LM, LAD, and left circumflex coronary artery (LCx), and thrombus aspiration.

KEYWORDS: Fondaparinux, coronary angioplasty, drug-eluting stent, left main coronary occlusion, catheter-related coronary thrombosis.


A 72-year-old woman was referred ...

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