An Unconventional Approach to Overcome the Extreme Angulation of LAD: A Challenging Percutaneous Coronary Intervention.

We herein describe a challenging acute anterior ST-elevation myocardial infarction (STEMI) case. The patient was hemodynamically unstable during the procedure and the extremely angulated culprit vessel hindered our repeated attempts of wiring. Procedural complexity and risks were increased not only due to angulation but also the bifurcational nature of the culprit lesion. We report an innovative solution that enabled the successful revascularisation of such a complex situation, after the failure of multiple attempts of conventional methods for wiring. We also briefly review the literature about recommended methods for such severely angulated vessels. Key Words: Angulation, infarction, Vessel, Angiography.