Key result
IVUS-guided emergent PCI proves feasible and successful for anterior STEMI in late pregnancy.
Why the study?
Acute myocardial infarction complicating pregnancy is rare and requires specialized management including revascularization, fetal radiation protection, and multidisciplinary coordination.
Case Report (n=1)
Emergent IVUS-guided percutaneous coronary intervention is feasible and safe for managing anterior STEMI in near-term pregnancy, even when followed by cesarean delivery on uninterrupted dual antiplatelet therapy.
Answers are grounded in this paper and cite their sources.
Radial-access PCI feasible in near-term pregnancy STEMI; leaves open need for prospective multicenter data on maternal-fetal outcomes.
BACKGROUND: Acute myocardial infarction complicating pregnancy is rare, with a maternal case-fatality rate of 4.5%. ST-elevation myocardial infarction in a near-term gravida requires revascularization, fetal radiation protection, and multidisciplinary coordination. CASE SUMMARY: A 32-year-old woman at 38 weeks of gestation with no cardiovascular risk factors presented with anterior STEMI from total left anterior descending artery occlusion. Emergent radial-access percutaneous coronary intervention was performed without sedation; intravascular ultrasound confirmed wire position through a thrombus-laden occlusion. Overlapping drug-eluting stents restored TIMI flow grade-3, with air kerma below fetal thresholds. Uninterrupted dual antiplatelet therapy continued through cesarean delivery, with blood loss controlled by hemostatic agents. Mother and neonate were discharged in good health. DISCUSSION: This case highlights the ambiguity between thrombotic occlusion and spontaneous dissection in pregnancy, the role of intravascular ultrasound when angiography is unreliable, and antiplatelet decision-making when surgery follows percutaneous coronary intervention. TAKE-HOME MESSAGES: Emergent intravascular ultrasound-guided percutaneous coronary intervention is feasible at 38 weeks of gestation. Multidisciplinary planning, radiation mitigation, and individualized antiplatelet strategy determine outcomes.
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Darko et al. (2026) conducted a case report in ST-elevation myocardial infarction during pregnancy (n=1). IVUS-guided percutaneous coronary intervention and cesarean delivery was evaluated. Emergent intravascular ultrasound-guided percutaneous coronary intervention was feasible and successfully performed in a 32-year-old woman at 38 weeks of gestation with anterior STEMI.
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