Conquering acute coronary syndrome in coronary artery ectasia: Thrombus resolution with intracoronary thrombolysis, aspiration thrombectomy, and triple therapy

We present a case of acute coronary syndrome in a patient with coronary artery ectasia. Intravascular imaging revealed complete thrombotic occlusion of the right coronary artery. Although initial aspiration thrombectomy was ineffective, intracoronary alteplase improved subsequent aspiration attempts. Medical management with anticoagulation alongside antiplatelet therapy reduced thrombotic burden with sustained effect.