A Challenging Scenario in a Patient with A ST Elevation Acute Myocardial Infarction

A seven French extra back-up catheter was placed in the ostium of the left coronary artery. Three guidewires were advanced: one in the LAD artery and the other two in the CX artery and branches. While crossing the CX occlusion with the wire, the vessel opened spontaneously (Figure 4) and an image suggestive of thrombotic material was seen in the CX and the second obtuse marginal branch (Figure 5). Afterwards, 15 mg of intracoronary abciximab were infused and a zotarolimus drug eluting stent (Resolute Integrity 3,5x22 mm) was placed directly from the CX artery to the second obtuse marginal branch (Figures 6 & 7).