The guide catheter was deliberately not engaged with the left main artery, as an occlusion was suspected. Here one can see contrast being injected towards the left main and a large thrombus sitting at the ostium. A small amount of flow is passing but not reaching further than proximal circumflex nor LAD. There is sluggish clearance of contrast from the aortic root indicative of poor cardiac output. An intra-aortic balloon pump can be seen inflating and deflating in the descending aorta.Smith comment: There is near total obstruction of the Left Main. #Clinical #EM #IM #Cardiology #Angiogram #LeftMainOcclusion
