Pre-stent acute thrombotic LAD occlusion

This is a 58-years old man who had an LAD stent inserted for a critical lesion.

Four days after the stent placement, the patient had severe chest pain. A cardiac CT was performed (Fig. 1-3), which shows complete occlusion of the LAD at its origin (blue arrows) and no contrast within the stent (white arrows). Fig. 2 shows hypodensity within the vessel with mild expansion of the vessel (blue arrow), suggestive of a thrombus. The catheter angiogram done later shows the stent (Fig. 4) and the acute pre-stent occlusion (Fig. 5)