Successful treatment of a left main thrombus by intracoronary eptifibatide infusion in a 36-year-old patient

The acute coronary syndrome due to the left main coronary artery [LMCA] thrombosis is a clinically rare and catastrophic event. We describe a young man [smoker, alcoholic, and drug abuser] with a history of recent surgery and typical chest pain who had non-occlusive LMCA thrombosis in coronary angiography. The thrombosis was successfully treated with two 180 micro/kg intracoronary boluses of eptifibatide, which was continued through an intravenous infusion at 2 micro/kg/min for 48 hours postprocedurally. Control angiography, performed 3 days later, revealed that the LMCA was free of thrombosis. The patient had no complaints, including chest pain, and remained completely asymptomatic during the next 30 days' follow-up