Percutaneous non-stenting approach for distal simultaneous multivessel acute coronary occlusions

Muhammad Nasir Rahman, Bilal Hussain

Research output: Contribution to journalArticlepeer-review


The occurrence of distal coronary lesions causing simultaneous occlusion of two coronary arteries in the setting of ST elevation myocardial infarction is a rare occurrence. This can occur due to simultaneous plaque rupture at more than one site or embolisation in coronary arteries. We describe a case of a middle-aged man who presented with acute inferoposterior lateral wall ST elevation myocardial infarction with simultaneous occlusion of distal left anterior descending artery and distal left circumflex artery on angiogram. The patient was treated with intracoronary streptokinase, followed by glycoprotein (GP) IIb/IIIa inhibitor and Factor X inhibitor (Rivaroxaban) with full resolution of flow in the distal vessels. Thus, coronary lesions, not amenable to stenting, can be dealt percutaneously, using a combination of old and newer pharmacological agents without stenting.

Original languageEnglish
Pages (from-to)398-400
Number of pages3
JournalJournal of the College of Physicians and Surgeons--Pakistan : JCPSP
Issue number5
Publication statusPublished - 1 May 2018


  • Intracoronary streptokinase
  • Simultaneous coronary occlusions


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