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Case Reports in Cardiology
Volume 2018, Article ID 6148470, 4 pages
Case Report

Multiple Culprit Coronary Artery Thrombosis in a Patient with Coronary Ectasia

Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil

Correspondence should be addressed to Bruno da Silva Matte; rb.ude.apch@ettamb

Received 20 July 2017; Revised 4 November 2017; Accepted 26 November 2017; Published 14 January 2018

Academic Editor: Manabu Shirotani

Copyright © 2018 Bruno da Silva Matte et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


We here report a case of ST-elevation myocardial infarction (STEMI) due to simultaneous acute coronary artery occlusions of two major coronary arteries in a patient with coronary ectasia. The patient had been previously submitted to percutaneous coronary angioplasty with bare metal stent implantation in both culprit vessels. Very late stent thrombosis could be the cause of the first occlusion, triggering the event in the other vessel. In addition, concomitant embolic sources were not identified. Although routine aspiration thrombectomy in STEMI was not proven to be beneficial in randomized clinical trials, it was of great value in this case. We also discuss the relation between coronary ectasia, chronic inflammatory status, and increased platelet activity which may have caused plaque disruption in another already vulnerable vessel.