Abstract
positioning, the case was considered unsuitable for distal protection device. We proceeded with plain balloon angioplasty. A 4.0×16mm balloon was placed and inflated up to 16 atm. After angioplasty the angiographic result was acceptable with little residual haziness. IVUS study revealed organized thrombus adhered to the vessel wall and a non-obstructive atherosclerotic plaque (Figure 1D). The patient was put on medical therapy (aspirin + klopidogrel + coumadin) and discharged. Coronary angiography which was performed two months after the angioplasty revealed normal coronary arteries (Figure 1C). Discussion: Younger patients presenting with ACS generally have a larger thrombus burden in the absence of a significant coronary stenosis. In patients who have a large thrombus burden and no significant coronary stenosis, plain balloon angioplasty without stenting may provide an optimal solution saving the patient from issues related to stenting.
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