Acute percutaneous transluminal coronary angioplasty complicated by embolism to a coronary artery remote from the site of infarction

Abstract

Percutaneous transluminal coronary angioplasty has emerged as a mode of treatment in patients with both chronic and acute coronary syndromes. Among the recognized complications of coronary angioplasty is coronary embolism. This case report describes a case of acute anterior myocardial infarction which was treated with angioplasty of the left anterior descending coronary artery. Postdilation angiography revealed obstruction of the posterior descending artery (in a left dominant system). The use of thrombolytic therapy previous to angioplasty is briefly discussed.

Acute occlusion of a remote coronary artery complicating directional coronary atherectomy

“…Embolization of thrombus into a remote coronary artery during angioplasty has been reported once [4]. However, this seems to be rare.…”

“…Occlusion of a non-instrumented artery during coronary interventions is rare. Several large angioplasty series have not reported this complication [ 1-31, and only a single case has been reported of occlusion of a remote coronary artery during angioplasty [4]. While 43 abrupt closures in the target artery have been reported in patients undergoing directional coronary atherectomy [ 5 ] , only one case of occlusion of the non-instrumented artery has been described [6].…”

“Back-squeezing” of the clot: An unusual complication of primary coronary angioplasty

“…Reviewing the literature, we only found two reports concerning this complication: one described the occlusion of the posterior descending artery of the circumflex after dilatation of an occlusion of the middle segment of the LAD in a patient with an anterior AMI [5]. This occlusion of the posterior descending artery was thought to be the result of migration of thrombotic material during catheter manipulation or removal.…”