Healed Erosion: The Role of Pre-interventional Optical Coherence Tomography in a Patient Clinically Suspected of Having Unstable Angina with Coronary Spasm |
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Authors: | Hiroki Okabe Shinjo Sonoda Yutaro Naka Koshi Setoyama Konosuke Inoue Toshiya Miura Reo Anai Yuki Tsuda Masaru Araki Yutaka Otsuji |
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Affiliation: | 1.The Second Department of Internal Medicine, University of Occupational and Environmental Health, Japan |
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Abstract: | 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. |
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Keywords: | healed plaque optical coherence tomography drug-coated balloon coronary spasm |
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