Case 211: Manual of CTO PCI - Thrombus

A patient was referred for PCI of a proximal circumflex CTO due to medically refractory angina. Antegrade wiring resulted in extraplaque crossing. Using the Stingray balloon reentry into the distal true lumen was achieved with a nice result after stenting. Suddenly the patient developed chest pain and ST elevation and was found to have a filling defect in the LAD. ACT was 271 sec. After administration of a GP IIb/IIIa inhibitor and vasodilators and aspiration using the Penumbra device the filling defect resolved. The patient had an uneventful recovery.

[@shangz0216]

Thanks for the educative case presentation.

[@Sradhananda15]

Excellent work Sir.

[@ahmedsabbar9049]

❤, it seems to me there is residual lesion in mid LAD segment where the thrombus is formed, thank you very much for sharing.