Author + information
- Zhe-Zhong Lin1
Patient initials or identifier number
Relevant clinical history and physical exam
A 60-year-old man suffered from syncope. He was sent to our emergency department by the ambulance. At the arrival of ER, the ECG showed ST elevation in lead aVR and V1,& ST depression in other leads. Primary PCI was done.
Relevant test results prior to catheterization
Renal function was good.
Relevant catheterization findings
CAG showed LM total occlusion. mRCA 90% stenosis.
Primary PCI was accessed with femoral artery. IABP was put before primary PCI. LCA was engaged with ECU guiding catheter. CAG showed LM total collusion. Thrombectomy was done by thrombuster V3. TIMI 1∼2 in LAD After Thrombectomy. However, the Sion blue wire failed to advance to LAD-P, which causing no reflow in LAD. BP dropped. CPCR was done and then ECMO was used. Thrombectomy was done by 5Fr Terumo ST01 again. The curve from LM to LAD was 300 degree so reverse wire technique with ASAHI Fielder FC wire. ASAHI Fielder FC wire to LAD-D. We put a bare metal stent between LM and LAD.
1. Heart team oriented for Left Main ST Elevation Myocardial Infarction
2. 5Fr ST01 for thrombectomy for Left Main or Left Anterior Descending-P thrombus
3. Three cm for reverse wire technique is basic.