In the early morning hours, a 44 year old male cigarette smoker with a familial history of cardiovascular disease collapsed on his way to work.

He was brought to the coronary unit because of persisting chest pain. An acute myocardial infarction (figure 1a) was diagnosed and the patient was transferred for primary coronary intervention. The angiography demonstrated an acute occlusion of the right coronary artery (figure 2). Immediately, a Soft Reflex (J&J, Cordis, NJ - USA) guide wire was utilized to cross the occlusion under proximal protection with Proxis™ (SJM, MN - USA) through a JL right 4.0 7F Zuma (Medtronic, MN - USA) guiding catheter (figure 3). The occlusion was pre-dilated with a 2.0/20mm Sprinter (Medtronic, MN - USA) balloon, under proximal protection. Thereafter a 3.5 mm 18 mm Cypher (J&J, Cordis, NJ - USA) stent was implanted at 16...continua a leggere