Antiphospholipid antibody syndrome is a heterogeneous clinical and biochemical condition. We present the case of a young male with a history of venous thromboembolism. This time he presents due to chest ischemic pain associated with ST-segment elevation. He was taken to the cath lab to perform a primary percutaneous coronary intervention, and a total occlusion of the left anterior descending artery was noted. Successful thrombus aspiration was performed. No stent was deployed. He was taken to the cath lab for a second look angiography, and no atherosclerotic lesions were observed, which was confirmed by intravascular ultrasound.

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