An Example of Angiographic Projection “Fine Tuning” in Primary PCI for Acute Anterior Myocardial Infarction

Konstantinos Triantafyllou


A 52-year-old gentleman was admitted with acute anterior myocardial infarction. He was submitted to emergency coronary angiography intending to perform primary percutaneous coronary intervention (PCI). The left anterior descending (LAD) coronary artery was missing. The standard initial angiographic projections failed to reveal the stump of the very proximally occluded LAD, which was consistently hidden by the proximal part of the left circumflex artery. Only the right anterior oblique cranial view, after slightly modifying the initial angle, finally delineated the LAD stump.  Primary PCI was successfully performed and the patient had an uncomplicated in-hospital course.


acute myocardial infarction; percutaneous coronary intervention; primary PCI; coronary angiography

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