Case Presentation 2 The Clot That Would Not Go Away !!

A 58-year-old man presented with Hyperacute Inf MI, the patient had a history of CABG 10 years ago.At presentation the patient complained of typical chest pain, hemodynamically stable and physical exam unremarkable. Primary PCI undertaken 3AM, the angiography revealed total occlusion of left system, CTO native RCA, patent LIMA, patent SVG on OM & clot filled SVG on RCA.Considering the option of opening a native RCA due to CTO nature was out of the question so we intervened for the SVG graft which was clot filled after numerous passage of Thrombosuction catheters we still could not establish forward flow. It seemed that a large clot was occluding the proximal RCA, the patients symptoms were deteriorating and he was getting hemodynamically unstable. The circumstances needed an urgent remedy to overcome this grave situation……