Key result
Thrombus aspiration and medical therapy successfully manage inferior STEMI in an anomalous single coronary artery.
Why the study?
ST-segment elevation myocardial infarction in an anomalous single coronary artery with high take-off is a rare clinical occurrence with very few cases reported to date.
Case Report (n=1)
This case highlights the successful individualized management of a rare STEMI in an anomalous single coronary artery using thrombus aspiration and medical therapy without stenting.
Hypothesis-generating for aspiration thrombectomy without stenting in anomalous coronary STEMI; prospective data needed before broader adoption.
BACKGROUND: ST-segment elevation myocardial infarction in an anomalous single coronary artery with high take-off is a rare occurrence with very few cases reported to date. CASE SUMMARY: A 42-year-old man with testicular seminoma undergoing chemotherapy presented with an inferior ST-segment elevation myocardial infarction. Coronary angiography revealed a thrombotic lesion of the anomalous single coronary artery. The patient underwent percutaneous intervention with thrombus aspiration, was managed with dual-antiplatelet therapy and anticoagulation, and was followed up in an outpatient setting with a computed tomography angiogram. DISCUSSION: Stenting was deferred, considering the patient's complex coronary anatomy and overall clinical condition. The possible mechanism of the event may be multifactorial but is likely to be precipitated by the recent chemotherapy-associated vascular toxicity. TAKE-HOME MESSAGES: This case highlights the diagnostic and therapeutic challenges of such unusual clinical presentations, highlighting the importance of multimodality evaluation and treatment, which should be individualized to each patient scenario.
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Karumuri et al. (2025) conducted a case report in ST-segment elevation myocardial infarction (n=1). Percutaneous intervention with thrombus aspiration was evaluated. Percutaneous intervention with thrombus aspiration and medical therapy successfully managed an inferior STEMI in a 42-year-old man with an anomalous single coronary artery.
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