Three cases of left main stem thrombus complicating PCI: the role of FilterWire protection for the virgin territory.

We report on three cases of left main stem thrombosis complicating percutaneous coronary angioplasty. We focused on the issue of dealing with emboli in the non-culprit vessel, as embolism in the "virgin" vessel is often associated with severe cardiogenic shock. We describe the use of a FilterWire technique to protect the non-culprit vessel and a case in which the FilterWire was occluded by thrombus leading to shock. The third case illustrates the difficulty with FilterWire protection if stenting is required in the left main stem itself.