Key result
Aspiration thrombectomy combined with triple antithrombotic therapy successfully resolves STEMI in coronary artery ectasia.
Why the study?
Coronary artery ectasia poses a risk for thrombus formation and acute coronary events owing to disrupted flow dynamics.
Case Report (n=1)
No
Coronary artery ectasia can precipitate STEMI via massive thrombus formation and can be successfully managed without stenting using mechanical thrombectomy and intensive antithrombotic therapy.
May support stent-free management in ectasia-related STEMI; hypothesis-generating pending prospective data.
BACKGROUND: Coronary artery ectasia (CAE) is a rare vascular abnormality characterized by diffuse coronary dilation. It poses a risk for thrombus formation and acute coronary events owing to disrupted flow dynamics. CASE SUMMARY: A 61-year-old man with aortoiliac aneurysms, dyslipidemia, and hypertension presented to the emergency room with chest pain and elevated troponins. Coronary angiography revealed diffuse ectasia with heavy thrombus burden in the right coronary artery. Partial thrombectomy and glycoprotein IIb/IIIa inhibitor therapy were administered. Follow-up angiography showed an organizing thrombus. The patient was treated with triple antithrombotic therapy and was discharged in stable condition. DISCUSSION: This case highlights the thrombotic complications of CAE and reviews strategies for diagnosis, risk stratification, and therapeutic interventions. TAKE-HOME MESSAGE: Coronary artery ectasia can present as acute coronary syndrome due to thrombus formation. Treatment often requires both catheter-based intervention and aggressive medical therapy.
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Ali et al. (2025) conducted a case report in Coronary artery ectasia presenting as STEMI (n=1). Mechanical thrombectomy and medical therapy (glycoprotein IIb/IIIa inhibitor and triple antithrombotic therapy) was evaluated. A 61-year-old man with coronary artery ectasia and STEMI was successfully treated using a combination of mechanical thrombectomy and pharmacologic triple antithrombotic therapy.
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