Healed Erosion: The Role of Pre-interventional Optical Coherence Tomography in a Patient Clinically Suspected of Having Unstable Angina with Coronary Spasm.
A 46-year-old man complained of chest pain at rest for the past three months. His symptoms gradually exacerbated and were suspected of being due to unstable angina. A coronary angiogram revealed focal tight stenosis at the proximal left anterior descending coronary artery with gross spastic coronary findings. Optical coherence tomography (OCT) revealed layered low-intensity structures with microvessels and the accumulation of macrophages, which indicated progressive stenosis with multiple-layered organized thrombus caused by coronary erosion. We treated the stenosis using a drug-coated balloon instead of drug-eluting stents. There was no restenosis, and OCT revealed good plaque healing at follow-up. This case suggests that the pre-interventional OCT plaque morphology can have a positive impact on the revascularization strategy.
['Okabe|Hiroki|H|', 'Sonoda|Shinjo|S|', 'Naka|Yutaro|Y|', 'Setoyama|Koshi|K|', 'Inoue|Konosuke|K|', 'Miura|Toshiya|T|', 'Anai|Reo|R|', 'Tsuda|Yuki|Y|', 'Araki|Masaru|M|', 'Otsuji|Yutaka|Y|']
D000789:Angina, Unstable D017023:Coronary Angiography D023903:Coronary Restenosis D003329:Coronary Vasospasm D003331:Coronary Vessels D006801:Humans D008297:Male D008875:Middle Aged D013035:Spasm D041623:Tomography, Optical Coherence D016896:Treatment Outcome
optical coherence tomography coronary spasm drug-coated balloon healed plaque