Coronary Traffic Jam Caused by a Trifurcating Left Main in a Cardiac Arrest STEMI Patient

Case Report: A 64 year old male presented to the emergency room as a case of cardiogenic shock. He had history of previous percutaneous coronary intervention (PCI) to left anterior descending artery (LAD) two years ago.ECG taken at emergency room (ER) showed acute inferolateral ST elevation myocardial infarction (STEMI). Coronary angiogram (CAG) revealed trifurcating left main with ramus as the culprit lesion. PCI of trifurcating left main (LM) is a complex procedure. But the challenge was overlapping previous LAD stent in the setting of trifurcating left main with acute angles between LAD, Ramus and LCx with medina classification (1 1 0 1).