Thrombotic occlusion of a large septal perforator presenting as ST-segment elevation in V1-V2 and treated with aspiration thrombectomy: a brief review of the literature

The interventricular septum constitutes approximately one-third of the mass of the left ventricle, and the bulk of the anterior septum is supplied by septal branches of the left anterior descending coronary artery. Ischemia of the interventricular septum results in angina, infarction, biventricular failure and ventricular arrhythmias. While the majority of septal infarctions are due to occlusions of the proximal left anterior descending coronary artery, a large first septal branch thrombosis can rarely be the culprit. Given the paucity of data pertaining to septal perforator disease, a thorough discussion on septal perforator coronary artery interventions and an illustrative case will be provided.