Endovascular Imaging and 3-Dimensional Reconstruction of Spontaneous Coronary Artery Dissection

A 57-year-old woman without coronary risk factors presented with non–ST-segment elevation myocardial infarction. Angiography revealed a normal anterior descending artery with lumen irregularities in the middle part (A, B, C) . Intravascular ultrasound (IVUS) (D, E, F) disclosed an intramural hematoma along the middle segment of the artery. Optical coherence tomography (OCT), resolution 15 μm, showed a proximal entry tear (G, H, arrow) , a large intramural hematoma (*) that compress the true lumen (TL) and a re-entry tear in the distal part (J) . The OCT 3-dimensional (3-D) reconstruction clearly visualize the spiral development of the dissection and the severe compression of ...
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