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We present a case of a spontaneously occurring mid LIMA dissection found on routine cardiac catheterization. We report our evaluation and intervention for this exceedingly rare phenomenon.

The finding of an intracoronary thrombus at the time of coronary angiography is common in patients presenting with an acute coronary syndrome. Pharmacologic and mechanical treatment strategies have been developed and reported to facilitate the treatment of the thrombus along with a percutaneous coronary intervention. We report a case in which a Pronto thrombectomy catheter was utilized to facilitate thrombus removal prior to the placement of a coronary stent in a patient who developed postinfarct angina and pulmonary edema after successful thrombolytic therapy for a acute ST segment elevation myocardial infarction.