We present 2 cases of acute coronary syndrome in patients with concomitant neoplastic disease during chemotherapy. In both patients, we found unusual angiographic image which showed that despite the presence of very large thrombi, there were no or hardly any atherosclerotic lesions in the vessel occlusion site. Aspiration thrombectomy was successfully performed in both cases to restore coronary flow and in the second patient, two bare metal stents were also implanted. After the patients were discharged from hospital, we decided to add enoxaparin to the routine dual antiplatelet therapy of both of them. So far, no guidelines have been developed on how to manage patients with acute coronary syndrome and concomitant neoplastic diseases while on chemotherapy.
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