Internal Mammary Artery Atherosclerosis Use of Optical Coherence Tomography to Characterize Lesions and Guide Intervention
A 59-year-old man with prior coronary artery bypass surgery underwent cardiac catheterization for worsening angina. Angiogram showed severe native coronary artery disease with 2 patent vein grafts. However, a left internal mammary artery graft to the left anterior descending artery was found to have a long lesion (Figure 1 ). Spasm was excluded by intra-arterial nitroglycerin administration. After discussing the options, optical coherence tomography (OCT)–guided percutaneous intervention was pursued.