Why the study?
Diffuse coronary artery ectasia predisposes to abnormal flow, thrombosis, and adverse cardiovascular outcomes, complicating acute coronary syndrome management.
Case Report (n=1)
No
STEMI management in patients with diffuse coronary artery ectasia is challenging due to massive thrombus burden and malapposition risks with stenting, highlighting the potential role of individualized antithrombotic therapy.
BACKGROUND: Coronary artery ectasia (CAE) predisposes to abnormal flow, thrombosis, and adverse cardiovascular outcomes. CASE SUMMARY: A 72-year-old woman with diffuse multivessel CAE, systemic arterial ectasia, and psoriasis presented with inferior ST-segment elevation myocardial infarction in the setting of left bundle branch block. Angiography demonstrated an approximately 8-mm ectatic right coronary artery with complete thrombotic occlusion. Aspiration thrombectomy restored partial flow, but stenting was deferred because of diffuse ectasia, persistent thrombus, and malapposition risk. She was discharged on a direct oral anticoagulant plus single antiplatelet therapy. DISCUSSION: Diffuse CAE is a high-risk thrombotic substrate, and ST-segment elevation myocardial infarction management is challenging because of altered flow, large thrombus burden, and percutaneous coronary intervention limitations. TAKE-HOME MESSAGE: Diffuse systemic ectasia warrants individualized antithrombotic therapy and longitudinal imaging surveillance.
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Gonnah et al. (2026) conducted a case report in Acute Coronary Syndrome in Severe Diffuse Coronary Artery Ectasia (n=1). Aspiration thrombectomy and direct oral anticoagulant plus single antiplatelet therapy was evaluated.
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