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Intramyocardial septal branches of a “dual LAD” selectively visualised within a no reflow area
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A 75 year old man was admitted to our coronary care unit with anterolateral ST elevation myocardial infarction (STEMI). After intravenous treatment with aspirin and nitrates, the patient underwent urgent coronary angiography that documented occlusion of the proximal left anterior descending coronary artery (LAD), with TIMI 0 flow (panel A). After crossing the lesion with the guidewires, a large thrombus became evident (panel B). During the procedure “dual LAD” anatomy was documented with a bifurcation of the LAD into …