Diagnosis and treatment of angiographically unclear coronary lesions.
J Int Med Res
; 52(1): 3000605231213753, 2024 Jan.
Article
em En
| MEDLINE
| ID: mdl-38179714
ABSTRACT
Although selective coronary angiography is the gold standard diagnostic technique for coronary lesions, this method does not provide all information regarding pathophysiologic mechanisms. We herein describe a patient in their early 60s with a 3-month history of pronounced angina. Coronary angiography revealed a central line of illumination in the proximomedial segment of the right coronary artery, suggesting a chronic coronary dissection/recanalized thrombus, along with positive remodeling and TIMI grade 2 flow. Optical coherence tomography showed a recanalized thrombus and multiple lumens separated by thin septa. Because of the significantly reduced flow and signs of ischemia in the right coronary artery irrigation territory, we decided to perform percutaneous coronary intervention. Post-treatment optical coherence tomography indicated optimal apposition and expansion of the stents with positive remodeling of the blood vessel. We believe that decisions regarding treatment modalities should be guided by the presence or absence of ischemia. Lesions that are causing myocardial ischemia should be revascularized; otherwise, medical treatment can be utilized.
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Base de dados:
MEDLINE
Assunto principal:
Trombose
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Doença da Artéria Coronariana
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Stents Farmacológicos
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Intervenção Coronária Percutânea
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article