Difficult Wiring of a Recanalized Thrombotic Lesion in the Right Coronary Artery Analyzed with Optical Coherence Tomography.
Am J Case Rep
; 19: 941-945, 2018 Aug 11.
Article
in En
| MEDLINE
| ID: mdl-30097560
ABSTRACT
BACKGROUND Recanalized thrombi are usually unrecognized in conventional coronary angiography. However, multiple channels have been observed in recanalized thrombotic lesions. Therefore, the wire apparently crosses the lesion in some difficult cases. We analyzed the cause of difficult wiring of a recanalized thrombotic lesion using optical coherence tomography (OCT). CASE REPORT An 87-year-old man with chest pain was admitted to our hospital. Coronary angiography showed significant stenosis of the proximal right coronary artery with irregular linear filling and haziness. Crossing of the wire for the lesion was very difficult but was achieved using a parallel wire technique. OCT clearly demonstrated multiple small channels which had ambiguous findings on angiography and intravascular ultrasound. These structures showed a honeycomb-like appearance suggests the recanalized thrombi. A drug-eluting stent was subsequently deployed to fully cover the entire lesion. CONCLUSIONS OCT is useful to evaluate the accurate tissue characteristics of a recanalized thrombotic lesion. Because recanalized thrombi have multiple small channels and since there are some cases in which a part of the channel only flows into a side branch, it is necessary to carefully monitor wiring at the time of percutaneous coronary intervention.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Coronary Thrombosis
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Coronary Angiography
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Coronary Vessels
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Coronary Stenosis
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Tomography, Optical Coherence
Limits:
Aged80
/
Humans
/
Male
Language:
En
Journal:
Am J Case Rep
Year:
2018
Type:
Article
Affiliation country:
Japan