Mario Iannaccone, MD, and Seth Bilizarian, MD, discuss hub center management, decision-making about immediate or delayed revascularization, PCI of thrombotic and dissected LAD, transitioning to the ICU and key learnings for spoke and hub care based on a clinical case that was performed by Dr. Iannaccone together with Dr. Matteo Attisani, Cardiac surgeon, Dr. Fabrizio Scalini, Cardiac surgeon, Dr. Alberto Capisani, Anesthesiologist, and Dr. Luca Franchin, second operator Cardiologist.