Journal of Medical Cases, ISSN 1923-4155 print, 1923-4163 online, Open Access
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Case Report

Volume 9, Number 8, August 2018, pages 243-245

“The Sticky LAD”: Large Intracoronary Thrombus in an Aneurysmal Left Anterior Descending Artery Presenting as ST-Elevation Myocardial Infarction

Figures

Figure 1.
Figure 1. Images above show an ectatic right coronary artery and left circumflex, free of significant disease.
Figure 2.
Figure 2. Images above show an ectatic left anterior descending coronary artery with note of a large, round, lucent structure in the proximal LAD, consistent with an intracoronary thrombus.
Figure 3.
Figure 3. Repeat angiogram after 2 weeks shows resolution of the intracoronary thrombus.

Table

Table 1. Cases Published Involving Intracoronary Thrombus
 
AuthorGeneral dataAngiogramManagement
Kuhl et al [5]75-year-old male, NSTE-ACSRCA: occluded with distal thrombusMedical: nitrates, heparin, aspirin, clopidogrel, long-term warfarin; PCI with stenting of the RCA
Lee et al [6]46-year-old male, STEMIRCA: totally occluded with large thrombus burdenMedical: eptifibatide, heparin, aspirin, clopidogrel, long-term warfarin; Thrombectomy; No stenting done
Varghese et al [7]22-year-old male, NSTE-ACSLAD: ectasia with thrombus in proximal LADMedical: eptifibatide, heparin, aspirin, clopidogrel, dabigatran; Aspiration thrombectomy and stenting