Distal Embolization of Thrombus in Acute Myocardial Infarction

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Distal Embolization of Thrombus in Acute Myocardial Infarction Ajay J. Kirtane, MD, SM, C. Michael Gibson, MS, MD The American Journal of Medicine Volume 119, Issue 12, Pages e1-e2 (December 2006) DOI: 10.1016/j.amjmed.2006.08.019 Copyright © 2006 Elsevier Inc. Terms and Conditions

Figure 1 Right coronary artery is depicted in the left anterior oblique projection. In the midsegment of the artery, obstructive thrombus is evident as a radiolucent filling defect (arrow). The American Journal of Medicine 2006 119, e1-e2DOI: (10.1016/j.amjmed.2006.08.019) Copyright © 2006 Elsevier Inc. Terms and Conditions

Figure 2 Right coronary artery is again depicted in the left anterior oblique projection in a subsequent image obtained during the same cineangiographic run as Figure 1. As contrast was injected, a portion of the thrombus was liberated and is now shown in migration more distally in the artery (arrow). The American Journal of Medicine 2006 119, e1-e2DOI: (10.1016/j.amjmed.2006.08.019) Copyright © 2006 Elsevier Inc. Terms and Conditions

Figure 3 Right coronary artery is depicted in the right anterior oblique projection in the next obtained cineangiographic run. Retained dye (from the prior injection) is visible in the distal branches of the posterior descending coronary artery (arrow), likely caused by distal embolization of the thrombus that resulted in “impaction” of the distal vasculature. The American Journal of Medicine 2006 119, e1-e2DOI: (10.1016/j.amjmed.2006.08.019) Copyright © 2006 Elsevier Inc. Terms and Conditions