What is your preferred anticoagulation/antiplatelet regimen for younger patients presenting with ACS, found to have an acute thrombotic event requiring aspiration thrombectomy without need for stent deployment?

Spontaneous in situ thrombosis of a coronary is rare, especially in the absence of a plaque rupture event. Malignancy-related coronary thrombotic occlusion, even with DOAC semi-compliance, is pathophysiologically difficult to understand, because coronary arteries are relatively high-flow areas, filing in systole and diastole.

This case likely represents an organized large thrombus (proximal vessel occlusion) from DVT, that has transited right to left, through a PFO flap to reach the arterial cir...

Interestingly, I had a young patient just like this a few weeks ago who presented with inferior wall STEMI. She was supposed to be taking Xarelto for a h/o recurrent DVT/PE (unclear workup as she was new to us and concerned about non-adherence to Xarelto).

After mechanical thrombectomy and manual aspiration thrombectomy, nearly the entire clot burden was removed from the proximal RCA. IVUS confirmed no plaque whatsoever and stenting was deferred. TIMI 3 flow was achieved. Intraprocedurally, we ...