title: Acute myocardial infarction with occlusion of all three main epicardial coronary arteries: when Mother Nature takes care more than physicians.
abstract: Double-arterial coronary stent thrombosis in acute myocardial infarction (AMI) is an infrequent but severe complication, especially when the third main coronary artery is chronically occluded. The conus artery (CA) can serve as a major source of collateral when the left anterior descendent coronary artery (LAD) becomes obstructed. We report a case of a 48-year-old man presenting with AMI due to a very late double-arterial stent thrombosis (ST) following drug-eluting stent implantation and a chronic occlusion of LAD collateralized by a large anomalous CA, which provided for the entire vascularization of the coronary tree.
authors.affiliation: Department of Cardiology, Policlinico University Hospital of Modena, Via del Pozzo 71, 41124, Modena, Italy. danielmonopoli@libero.it
authors.forename: Daniel E
authors.initials: DE
authors.lastname: Monopoli
authors.forename: Luigi
authors.initials: L
authors.lastname: Politi
authors.forename: Fabio
authors.initials: F
authors.lastname: Sgura
authors.forename: Rosario
authors.initials: R
authors.lastname: Rossi
authors.forename: Maria G
authors.initials: MG
authors.lastname: Modena
authors.forename: Giuseppe M
authors.initials: GM
authors.lastname: Sangiorgi
mesh_terms: D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects* / Q000295:instrumentation; D002908:Chronic Disease; D003097:Collateral Circulation; D003326:Coronary Circulation; D054059:Coronary Occlusion / Q000150:complications* / Q000503:physiopathology / Q000628:therapy; D003330:Coronary Vessel Anomalies / Q000150:complications* / Q000503:physiopathology / Q000628:therapy; D054855:Drug-Eluting Stents; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008670:Metals; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011474:Prosthesis Design; D015607:Stents; D013927:Thrombosis / Q000209:etiology* / Q000503:physiopathology; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents; D008670:Metals; D010975:Platelet Aggregation Inhibitors