Author + information
- Received July 12, 2012
- Revision received August 2, 2012
- Accepted August 16, 2012
- Published online November 1, 2012.
- Rodrigo Estévez-Loureiro, MD⁎ (, )
- Ramon Calviño-Santos, MD,
- Jorge Salgado-Fernández, MD,
- Angela López-Sainz, MD,
- Marcos García-Guimaraes, MD,
- Pablo Piñón-Esteban, MD,
- Guillermo Aldama-López, MD,
- Nicolás Vazquez-Gonzalez, MD and
- Alfonso Castro-Beiras, PhD
- ↵⁎Reprint requests and correspondence
: Dr. Rodrigo Estévez-Loureiro, Interventional Cardiology Unit, Hospital Universitario A Coruña, As Xubias de Arriba 84, 15006 A Coruña, Spain
A 65-year-old male was admitted to our institution due to atypical chest pain. His previous medical history revealed the presence of an anterior wall myocardial infarction that extended clinically silent 30 years ago. Angiographic images revealed the presence of a linear filling defect in the proximal left anterior descending artery (LAD) (Fig. 1). For further characterization of the lesion we decided to perform an intravascular ultrasound (IVUS), showing a coronary lumen divided into several cavities and partitioned by ultrasound tissue similar to the intima (Fig. 2). We also performed an optical coherence tomography study, where we can observe more clearly the multi-lumen appearance of the lesion but with more cavities than observed with IVUS and more clearly defined intima-like wall (Fig. 3). The most plausible mechanism for that image is the presence of an old thrombus (history of previous myocardial infarction) with subsequent recanalization and formation of multiple lumens.
Intracoronary diagnostic imaging techniques have given interventional cardiologists a better understanding of coronary disease and how to optimize percutaneous coronary interventions. Optical coherence tomography has become a key coronary imaging diagnostic tool and, due to its greater spatial resolution (15 μm), is able to better characterize the processes of atherosclerotic plaques, providing additional detailed structural information over IVUS imaging (1,2). Thus, optical coherence tomography might be useful as well to further characterize ambiguous angiographic images with better-quality images than IVUS.
All authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received July 12, 2012.
- Revision received August 2, 2012.
- Accepted August 16, 2012.
- American College of Cardiology Foundation
- Jang I.K.,
- Bouma B.E.,
- Kang D.H.,
- et al.