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Contrast media injection into right coronary artery caused thrombus extraction to aorta that may have resulted in left main trunk thrombosis

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Abstract

A 59-year-old man with inferior acute myocardial infarction underwent an urgent coronary angiography and as a result a total occlusion of the ostial right coronary artery (RCA) was observed. Interestingly, the thrombus in the RCA clearly shortened within 2.3 s during the contrast media injection. While we prepared for percutaneous coronary intervention (PCI) of the RCA, ventricular fibrillation occurred and pulseless electrical activity continued in spite of repeated cardioversion. Despite no stenosis in the left main trunk (LMT) in the initial coronary angiography, the LMT was totally occluded. Following aspiration therapy on the LMT with percutaneous cardiopulmonary support, PCI of the RCA was performed. A coronary angiography should be carefully performed if a lot of thrombi exist in the coronary ostium because LMT embolism may have been caused by thrombus extraction from the RCA by contrast media injection.

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Authors and Affiliations

  1. Division of Cardiology, Heart and Vascular Institute, Funabashi Municipal Medical Center, 1-21-1 Kanasugi, Funabashi, 273-8588, Chiba, Japan

    Atsushi Ikeda, Masayuki Inagaki, Shigeru Fukuzawa, Juji Sugioka, Shinichi Okino, Junpei Maekawa, Sachiko Maekawa, Soichiro Ichikawa, Takashi Uchiyama, Norihiko Kamioka & Nobuyuki Kuroiwa

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  1. Atsushi Ikeda
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  2. Masayuki Inagaki
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  3. Shigeru Fukuzawa
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  4. Juji Sugioka
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  5. Shinichi Okino
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  6. Junpei Maekawa
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  7. Sachiko Maekawa
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  8. Soichiro Ichikawa
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  9. Takashi Uchiyama
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  10. Norihiko Kamioka
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  11. Nobuyuki Kuroiwa
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Correspondence to Atsushi Ikeda.

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Ikeda, A., Inagaki, M., Fukuzawa, S. et al. Contrast media injection into right coronary artery caused thrombus extraction to aorta that may have resulted in left main trunk thrombosis. Cardiovasc Interv and Ther 27, 37–42 (2012). https://doi.org/10.1007/s12928-011-0082-z

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  • DOI: https://doi.org/10.1007/s12928-011-0082-z

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