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Utility of optical coherence tomography to assess a hazy intracoronary image after percutaneous coronary intervention.

Carrizo S, Salinas P, Jimenez-Valero S, Moreno R - Korean Circ J (2013)

Bottom Line: Based on the results of the OCT, the patient underwent an elective coronary angioplasty with standard anticoagulation.The use of OCT permitted a correct diagnosis and a successful treatment.This paper provides a discussion of the advantages and disadvantages of OCT, and a comparison with intravascular ultrasound.

View Article: PubMed Central - PubMed

Affiliation: University Hospital La Paz, Interventional Cardiology Department, Madrid, Spain.

ABSTRACT
Although its use in daily practice is not common, optical coherence tomography (OCT) is a powerful research tool in invasive cardiology. This report describes a hazy angiography image after percutaneous coronary intervention that has been assessed using OCT. Based on the results of the OCT, the patient underwent an elective coronary angioplasty with standard anticoagulation. After implantation of the stent, an intracoronary hazy image was seen on angiography. The use of OCT permitted a correct diagnosis and a successful treatment. This paper provides a discussion of the advantages and disadvantages of OCT, and a comparison with intravascular ultrasound.

No MeSH data available.


Intrastent luminal hazy image on the middle portion of the left anterior descendent coronary artery (arrow head).
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Figure 2: Intrastent luminal hazy image on the middle portion of the left anterior descendent coronary artery (arrow head).

Mentions: Ten hours before the second procedure, the patient was given a sub-cutaneous dose of 1 mg/kg enoxaparin. Following the current recommendation guidelines,5) we gave the patient a 0.3 mg/kg enoxaparine dose by intravenous administration immediately before the angioplasty procedure; we decided against giving the patient unfractionated heparin. We performed a predilatation procedure using a compliant balloon angioplasty in the LAD without angiographic complications, and after that we implanted a BMS of 2.5×23 mm. In the control post-PCI angiography, we found a focal, intra-stent repletion defect (Fig. 2), with distal Thrombolysis in Myocardial Infarction 3 flow. Because of the uncertain interpretation by angiography, we decided to perform OCT in order to ascertain the mechanism of the angiographic hazy image (dissection, thrombus, plaque prolapse). We used a C7-XR, Saint Jude OCT Frequency Domain System with a Dragon Fly Catheter (St. Jude Medical, St. Paul, MN, USA). The OCT study showed an intra-stent protruding signal rich mass with irregular borders and low-backscattering, a finding compatible with a white thrombus.


Utility of optical coherence tomography to assess a hazy intracoronary image after percutaneous coronary intervention.

Carrizo S, Salinas P, Jimenez-Valero S, Moreno R - Korean Circ J (2013)

Intrastent luminal hazy image on the middle portion of the left anterior descendent coronary artery (arrow head).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3569566&req=5

Figure 2: Intrastent luminal hazy image on the middle portion of the left anterior descendent coronary artery (arrow head).
Mentions: Ten hours before the second procedure, the patient was given a sub-cutaneous dose of 1 mg/kg enoxaparin. Following the current recommendation guidelines,5) we gave the patient a 0.3 mg/kg enoxaparine dose by intravenous administration immediately before the angioplasty procedure; we decided against giving the patient unfractionated heparin. We performed a predilatation procedure using a compliant balloon angioplasty in the LAD without angiographic complications, and after that we implanted a BMS of 2.5×23 mm. In the control post-PCI angiography, we found a focal, intra-stent repletion defect (Fig. 2), with distal Thrombolysis in Myocardial Infarction 3 flow. Because of the uncertain interpretation by angiography, we decided to perform OCT in order to ascertain the mechanism of the angiographic hazy image (dissection, thrombus, plaque prolapse). We used a C7-XR, Saint Jude OCT Frequency Domain System with a Dragon Fly Catheter (St. Jude Medical, St. Paul, MN, USA). The OCT study showed an intra-stent protruding signal rich mass with irregular borders and low-backscattering, a finding compatible with a white thrombus.

Bottom Line: Based on the results of the OCT, the patient underwent an elective coronary angioplasty with standard anticoagulation.The use of OCT permitted a correct diagnosis and a successful treatment.This paper provides a discussion of the advantages and disadvantages of OCT, and a comparison with intravascular ultrasound.

View Article: PubMed Central - PubMed

Affiliation: University Hospital La Paz, Interventional Cardiology Department, Madrid, Spain.

ABSTRACT
Although its use in daily practice is not common, optical coherence tomography (OCT) is a powerful research tool in invasive cardiology. This report describes a hazy angiography image after percutaneous coronary intervention that has been assessed using OCT. Based on the results of the OCT, the patient underwent an elective coronary angioplasty with standard anticoagulation. After implantation of the stent, an intracoronary hazy image was seen on angiography. The use of OCT permitted a correct diagnosis and a successful treatment. This paper provides a discussion of the advantages and disadvantages of OCT, and a comparison with intravascular ultrasound.

No MeSH data available.