Key result
Aspiration thrombectomy successfully treats STEMI caused by simultaneous two-vessel occlusion in coronary ectasia.
Why the study?
Simultaneous acute occlusions of two major coronary arteries in STEMI patients with coronary ectasia and previous stenting are rare and not well characterized.
Case Report (n=1)
Aspiration thrombectomy may be beneficial in specific cases of STEMI with multiple culprit coronary artery thrombosis and coronary ectasia, despite lack of routine benefit in RCTs.
May support aspiration thrombectomy in rare dual-occlusion STEMI with ectasia; hypothesis-generating and requires prospective validation.
We here report a case of ST-elevation myocardial infarction (STEMI) due to simultaneous acute coronary artery occlusions of two major coronary arteries in a patient with coronary ectasia. The patient had been previously submitted to percutaneous coronary angioplasty with bare metal stent implantation in both culprit vessels. Very late stent thrombosis could be the cause of the first occlusion, triggering the event in the other vessel. In addition, concomitant embolic sources were not identified. Although routine aspiration thrombectomy in STEMI was not proven to be beneficial in randomized clinical trials, it was of great value in this case. We also discuss the relation between coronary ectasia, chronic inflammatory status, and increased platelet activity which may have caused plaque disruption in another already vulnerable vessel.
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Matte et al. (2018) conducted a case report in ST-elevation myocardial infarction (STEMI) with coronary ectasia (n=1). Aspiration thrombectomy was evaluated. Aspiration thrombectomy was successfully used to treat a patient with STEMI caused by simultaneous acute occlusions of two major coronary arteries in the setting of coronary ectasia.
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