Key result
Primary PCI for LCx occlusion results in unexpected thrombus migration to the distal LAD.
This case report highlights thrombus migration as an unexpected complication during primary percutaneous coronary intervention.
Thrombus migration during high-burden LCx PCI warrants prophylactic LAD wiring; hypothesis-generating for this strategy in complex coronary interventions.
An 82-year-old woman with a high-risk non-ST-elevation myocardial infarction was admitted. Urgent coronary angiography revealed a proximal left circumflex total occlusion with a very high thrombus burden, a super-dominant right coronary artery, and an unobstructed left anterior descending artery.
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Theodoropoulos et al. (2026) studied this question. Primary percutaneous coronary intervention for a left circumflex occlusion was complicated by unexpected thrombus migration to the distal left anterior descending artery.
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