Cardiac Computed Tomography for Detecting Intracoronary Thrombotic Structures in Proximal LAD Bare Metal Stents

Abstract

Thrombus distribution is known part of atrial arrhythmias. We here report a clinical example using cardiac 256-multidetector row computed tomography (256 MDCT) for examination to assess for small intracoronary thrombotic structures in proximal parts of vessels with either big size (> 2,5 mm diameter) and/ or existing bare metal stents on a 70 years old male individual. He was suffering a non ST elevated myocardial infarction due to intracoronary thrombus in bare metal stents in the proximal left artery descending (LAD) in regard to occult atrial fibrillation. Philips 256 iCT documented the small amount of rest thrombus after abciximab pre treatment before discharge of the patient under acetylsalicylacid (100mg) and phenprocoumon (for 6 months). Summarised, this example proposes and underlines further use of cardiac MDCT for patients with acute chest pain to improve prognostic outcome by reduction of complications. Additionally, even 3 years after bare metal stent implantation in big vessels, here proximal LAD, we are mainly demonstrating the need of continuous antithrombotic acetylsalicylacid treatment to avoid in-stent thrombosis.