{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T18:32:43Z","timestamp":1786559563175,"version":"build-2736575974"},"reference-count":13,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:00:00Z","timestamp":1777507200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:00:00Z","timestamp":1777507200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Multivessel acute total occlusion (ATO) represents an exceedingly rare and catastrophic form of acute myocardial infarction (MI), characterized by complete cessation of coronary flow in multiple epicardial vessels and profound ischemic burden. Such extensive coronary involvement often precipitates cardiogenic shock and carries exceptionally high mortality. This case report describes a 51\u2010year\u2010old male who presented with syncope and persistent chest pain following vigorous exertion. On admission, electrocardiography indicated acute anteroseptal and high lateral wall MI, and echocardiography revealed left ventricular dysfunction (LVEF 36%) with regional wall motion abnormalities. Coronary angiography demonstrated multivessel ATO involving proximal\u2013mid left anterior descending (LAD) subtotal occlusion (TIMI 0\u20131), proximal left circumflex (LCx) total occlusion (TIMI 0), and mid right coronary artery (RCA) occlusion (TIMI 0). The patient developed cardiogenic shock requiring norepinephrine support. Guided by contemporary recommendations, culprit\u2010only percutaneous coronary intervention (PCI) of the LCx was performed via right radial access, with intracoronary administration of a glycoprotein IIb\/IIIa inhibitor (Prolifiban). A 2.75\u2009\u00d7\u200923\u2009mm drug\u2010eluting stent was successfully implanted, achieving full reperfusion (TIMI 3) and rapid hemodynamic recovery. Subsequent staged LAD intervention was also successful. Post\u2010procedural outcomes were favorable, with no recurrent syncope or chest pain and improved left ventricular ejection fraction to 46% at 30 days. This case highlights the clinical complexity and therapeutic dilemma of multivessel ATO presenting with syncope and cardiogenic shock. It underscores the importance of selective culprit\u2010lesion revascularization, radial access, and adjunctive pharmacotherapy in achieving stabilization and favorable outcomes in this high\u2010risk setting.<\/jats:p>","DOI":"10.1002\/ccd.70645","type":"journal-article","created":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T08:51:46Z","timestamp":1777539106000},"page":"263-268","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["From Syncope to Shock: Emergency PCI Case Report in Multivessel Acute Coronary Occlusion"],"prefix":"10.1002","volume":"108","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-7158-5663","authenticated-orcid":false,"given":"Nueraili","family":"Aimaierjiang","sequence":"first","affiliation":[{"name":"Department of Cardiology The First People's Hospital of Aksu Aksu 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Aksu Aksu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Cardiology Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School Nanjing 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