Excimer laser coronary angioplasty for managing acute myocardial infarction complicated by massive thrombosis in coronary artery ectasia: A case series

Coronary artery ectasia (CAE) complicates revascularization in ST-elevation myocardial infarction (STEMI) due to high thrombus burden. Excimer laser coronary angioplasty (ELCA) has proven effective in managing this, as shown in three acute myocardial infarction (AMI) cases with massive thrombosis in CAE. In Case 1, ELCA enabled thrombus aspiration after conventional methods failed. Case 2 achieved revascularization through escalated ELCA power, and Case 3 used repeated ELCA cycles to modify thrombus characteristics, allowing successful aspiration. ELCA's ability to debulk thrombi, modify their properties, and reduce platelet aggregation makes it a valuable strategy when conventional methods are insufficient. Acute myocardial infarction (AMI) with coronary artery ectasia (CAE) presents a challenge in revascularization due to the high thrombus burden. Excimer laser coronary angioplasty (ELCA) has shown promise for managing extensive thrombus burden within the coronary arteries. We present three cases of patients with AMI complicated by massive thrombosis in CAE who were successfully managed using ELCA. ELCA might be efficacious as a bail-out strategy for massive thrombus in AMI associated with CAE.