title: Complete Revascularization of Simultaneous Multiple Culprit Lesions in a Septuagenarian with ST-Elevation Myocardial Infarction.
abstract: BACKGROUND ST-elevation myocardial infarction (STEMI) is usually caused by rupture of unstable plaque with thrombus formation and abrupt cessation of blood flow through a single coronary artery that is deemed the culprit. The simultaneous thrombotic occlusions of multiple coronary arteries in the setting of STEMI is a rare occurrence with implications for patient management and outcome not fully addressed in the current STEMI guidelines, although more recent studies suggest a benefit of complete revascularization compared to culprit vessel-only treatment in the setting of STEMI. CASE REPORT A 74-year-old female presented with STEMI. Coronary angiography revealed simultaneous multiple coronary thrombotic occlusions involving the right coronary, left circumflex, and ramus intermedius arteries successfully treated with primary percutaneous revascularization at the same setting with good outcome and short hospital length of stay. CONCLUSIONS Although the most appropriate timing to treat simultaneous multiple culprit lesions has yet to be definitively defined, multi-vessel percutaneous coronary intervention in the setting of a STEMI with multiple culprit lesions is feasible with good outcome as shown by our index case.
authors.affiliation: Division of Cardiovascular Diseases, Department of Medicine, University of Tennesse Health Science Center, Memphis, TN, USA.
authors.forename: Ikechukwu A
authors.initials: IA
authors.lastname: Ifedili
authors.affiliation: Division of Cardiovascular Diseases, Department of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA.
authors.forename: Tamunoinemi
authors.initials: T
authors.lastname: Bob-Manuel
authors.affiliation: Division of Cardiovascular Diseases, Department of Medicine, University of Tennesse Health Science Center, Memphis, TN, USA.
authors.forename: Oluwaseyi
authors.initials: O
authors.lastname: Bolorunduro
authors.affiliation: Division of Cardiovascular Diseases, Department of Medicine, University of Tennesse Health Science Center, Memphis, TN, USA.
authors.forename: Raza
authors.initials: R
authors.lastname: Askari
authors.affiliation: Division of Cardiovascular Diseases, Department of Medicine, University of Tennesse Health Science Center, Memphis, TN, USA.
authors.forename: Uzoma N
authors.initials: UN
authors.lastname: Ibebuogu
mesh_terms: D054058:Acute Coronary Syndrome / Q000150:complications*; D000368:Aged; D000800:Angioplasty, Balloon / Q000379:methods; D054855:Drug-Eluting Stents; D004562:Electrocardiography; D005240:Feasibility Studies; D005260:Female; D006329:Heart Conduction System / Q000503:physiopathology; D006801:Humans; D062645:Percutaneous Coronary Intervention / Q000379:methods; D012307:Risk Factors; D000072657:ST Elevation Myocardial Infarction / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D016896:Treatment Outcome