Mechanical Thrombus Aspiration for a Young STEMI Patient With Plaque Erosion: Time for a Stent‐Free Approach?

Figures

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  Figure 1. Angiographic evidence of a subocclusive stenosis in the mid left anterior descending coronary artery, followed by thrombotic occlusion with a high thrombus burden.

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  Figure 2. Mechanical coronary thrombus aspiration with CAT‐RX Penumbra (Indigo) device.

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  Figure 3. Restoration of TIMI 3 antegrade coronary flow following effective mechanical coronary thrombus aspiration of the left anterior descending coronary artery.

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  Figure 4. Representative pre‐procedural and post‐procedural electrocardiograms demonstrating marked reduction of anterior ST‐segment elevation following mechanical thrombus aspiration and restoration of Thrombolysis In Myocardial Infarction (TIMI) 3 coronary flow. [Color figure can be viewed at wileyonlinelibrary.com]

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  Figure 5. Optical coherence tomography (OCT) assessment on the left anterior descending artery, demonstrating plaque erosion in the mid segment. [Color figure can be viewed at wileyonlinelibrary.com]

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  Figure 6. Optical coherence tomography (OCT) imaging demonstrating plaque erosion with adherent thrombotic foci overlying an intact fibrous cap in the mid‐segment of the left anterior descending coronary artery. [Color figure can be viewed at wileyonlinelibrary.com]

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  Figure 7. Optical coherence tomography (OCT) imaging demonstrating a large residual luminal area at the culprit site with a minimum lumen area (MLA) of 9.03 mm2. [Color figure can be viewed at wileyonlinelibrary.com]

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  Figure 8. Lesion assessment with evidence of mild residual stenosis of 28% with quantitative coronary angiography (QCA). [Color figure can be viewed at wileyonlinelibrary.com]

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  Figure 9. Coronary computed tomography angiography (CCTA) demonstrating epicardial coronary arteries free from significant stenosis at 1‐year follow‐up after the acute event. [Color figure can be viewed at wileyonlinelibrary.com]

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  Central Illustration 1. Overview of the case report with angiographic and intracoronary imaging evaluations along with the management strategy. [Color figure can be viewed at wileyonlinelibrary.com]