1. Articles from Amparo Benedicto

    1-13 of 13
    1. Coronary artery aneurysm formation following implantation of a bioresorbable vascular scaffold for in-stent restenosis

      Coronary artery aneurysm formation following implantation of a bioresorbable vascular scaffold for in-stent restenosis

      Coronary artery aneurysm (CAA) formation is a rare complication of coronary intervention that may develop after implantation of bare-metal or drug-eluting stents. The etiology of this entity appears to be multifactorial and its prognosis is poorly understood, but it has been associated with an increased risk of stent thrombosis. To date few cases of CAAs related to bioresorbable vascular scaffold (BVS) implantation have been reported, and the development of CAA after BVS implantation for the treatment of in-stent restenosis (ISR) has not been previously described. Here we present two cases of CAA formation after BVS, which represent the first demonstration ...

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      Mentions: Fernando Alfonso
    2. Multifaceted Presentation of Recurrent Spontaneous Coronary Artery Dissection Angiography and Optical Coherence Tomography Findings

      Multifaceted Presentation of Recurrent Spontaneous Coronary Artery Dissection Angiography and Optical Coherence Tomography Findings

      A 58-year-old woman with a previous history of hypertension, hypercholesterolemia, and cigarette smoking presented with a non–ST-segment–elevation myocardial infarction with transient (nonpersistent) anterior ST-segment–elevation suggesting ischemia on the territory of the left anterior descending coronary artery. The coronary angiogram showed no signs of atherosclerosis but depicted severely tortuous coronary arteries with a focal lumen narrowing in the mid-segment of the left anterior descending coronary artery (Figure 1A). In addition, a diffuse lesion with a double lumen was demonstrated at the mid-segment of the posterior descending coronary artery branch of the right coronary artery (Figure 1B). Moreover, the ...

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      Mentions: Fernando Alfonso
    3. Multifaceted Presentation of Recurrent Spontaneous Coronary Artery Dissection Angiography and Optical Coherence Tomography Findings

      Multifaceted Presentation of Recurrent Spontaneous Coronary Artery Dissection Angiography and Optical Coherence Tomography Findings

      A 58-year-old woman with a previous history of hypertension, hypercholesterolemia, and cigarette smoking presented with a non–ST-segment–elevation myocardial infarction with transient (nonpersistent) anterior ST-segment–elevation suggesting ischemia on the territory of the left anterior descending coronary artery. The coronary angiogram showed no signs of atherosclerosis but depicted severely tortuous coronary arteries with a focal lumen narrowing in the mid-segment of the left anterior descending coronary artery (Figure 1A). In addition, a diffuse lesion with a double lumen was demonstrated at the mid-segment of the posterior descending coronary artery branch of the right coronary artery (Figure 1B). Moreover, the ...

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      Mentions: Fernando Alfonso
    4. Mother-and-child catheter-facilitated optical coherence tomography: A novel approach to improve intracoronary imaging

      Mother-and-child catheter-facilitated optical coherence tomography: A novel approach to improve intracoronary imaging

      Background: Our aim was to prospectively analyze the usefulness of mother-and-child catheter approach with the GuideLiner® (GL) catheter extension system to overcome some potential limitations associated with the use of optical coherence tomography (OCT). Methods: We included consecutive patients referred to our institution for coronary angiogram in whom OCT image acquisition was obtained using GL. From February 2015 to May 2016, a total of 19 procedures (18 patients) were prospectively included. Results: In more than two thirds of the procedures, the OCT catheter was unable to cross the coronary stenosis prior to the use of GL. The right coronary artery ...

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      Mentions: Fernando Alfonso
    5. Coronary Pleating Mimicking Coronary Ruptures, Dissections, and Thrombi on Optical Coherence Tomography

      Coronary Pleating Mimicking Coronary Ruptures, Dissections, and Thrombi on Optical Coherence Tomography

      Introduction Straightening of tortuous coronaries by intracoronary guidewires may generate intimal wrinkles or coronary pleating and lead to the development of different abnormal angiographic findings widely known as pseudostenosis or accordion effect. 1 We report the unique findings disclosed by optical coherence tomography (OCT) in 3 patients developing coronary pleating. Patient 1 An 84-year-old woman with severe aortic stenosis was referred for coronary angiography before transcatheter aortic valve implantation. A severe stenosis in the mid segment of the right coronary artery was treated with a bare metal stent. The guidewire induced a new moderate focal lesion at the most proximal ...

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      Mentions: Fernando Alfonso
    6. Coronary Pleating Mimicking Coronary Ruptures, Dissections, and Thrombi on Optical Coherence Tomography

      Coronary Pleating Mimicking Coronary Ruptures, Dissections, and Thrombi on Optical Coherence Tomography

      Introduction Straightening of tortuous coronaries by intracoronary guidewires may generate intimal wrinkles or coronary pleating and lead to the development of different abnormal angiographic findings widely known as pseudostenosis or accordion effect. We report the unique findings disclosed by optical coherence tomography (OCT) in 3 patients developing coronary pleating. Patient 1 An 84-year-old woman with severe aortic stenosis was referred for coronary angiography before transcatheter aortic valve implantation. A severe stenosis in the mid segment of the right coronary artery was treated with a bare metal stent. The guidewire induced a new moderate focal lesion at the most proximal segment ...

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      Mentions: Fernando Alfonso
    7. In-Stent Restenosis Caused by a Calcified Nodule: A Novel Pattern of Neoatherosclerosis

      In-Stent Restenosis Caused by a Calcified Nodule: A Novel Pattern of Neoatherosclerosis

      Neoatherosclerosis has been described as a cause of in-stent restenosis particularly in patients treated with drug-eluting stents. Although neoatherosclerosis may present as calcified plaques the occurrence of a “calcified nodule” within the stent has not been previously reported. We describe optical coherence tomography findings in patient presenting with a calcified nodule causing “undilatable” in-stent restenosis 2 years after implantation of a drug-eluting stent. The clinical and technical implications of this novel pattern of neoatherosclerosis are discussed.

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      Mentions: Fernando Alfonso
    8. Phantom Stent Thrombosis: Intracoronary Imaging Insights

      Phantom Stent Thrombosis: Intracoronary Imaging Insights

      A 72-old-year-man was admitted for an inferior ST-segment elevation acute myocardial infarction. Seven years earlier, a 2.75 × 15-mm bare-metal stent (BMS) was successfully implanted in the posterolateral branch of the right coronary artery (RCA) at another institution. Emergent coronary angiography showed a thrombotic occlusion at the mid-segment of the RCA (Figure 1 ). After multiple unsuccessful attempts to cross the occlusion, eventually a hydrophilic guidewire was advanced across the occluded segment. Thromboaspiration was unsuccessful despite the use of 2 different aspiration devices that were unable to cross the lesion. Optical coherence tomography (OCT) was performed to clarify the underlying substrate ...

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      Mentions: Fernando Alfonso
    9. Kounis Syndrome: Optical Coherence Tomography Findings

      Kounis Syndrome: Optical Coherence Tomography Findings

      A 59-year-old man, smoker and with a past history of hypertension, was admitted to the emergency department because of a generalized erythema and hypotension after taking an oral dose of amoxicillin/clavulanic acid for a toe cellulitis. At first medical contact, the patient presented with hypotension (70/40 mmHg), excessive sweating and a striking rash with urticaria on this back. The electrocardiogram showed ST-segment depression in leads III, aVF and V3-V6. After saline and aspirin administration the symptomatology was gradually relieved and the ST-segment changes normalized.

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      Mentions: Fernando Alfonso
    10. Treatment of In-Stent Restenosis With Bioresorbable Vascular Scaffolds: Optical Coherence Tomography Insights

      Treatment of In-Stent Restenosis With Bioresorbable Vascular Scaffolds: Optical Coherence Tomography Insights

      The role of bioresorbable vascular scaffolds (BVS) in patients with in-stent restenosis (ISR) remains unsettled. We present optical coherence tomography (OCT) findings in a series of 15 consecutive patients undergoing treatment of ISR with BVS under systematic OCT guidance. OCT disclosed severe ISR in all patients (minimal lumen area (MLA) 1.3±0.6 mm 2 ; stent obstruction 80±10%). After the procedure OCT MLA was 6.4±2 mm 2 with a final BVS expansion of 79±19%. “ Angiographically silent” edge-dissections (n=6), intra-device-dissections (n=3), tissue prolapse (n=3) and malapposition (n=3) were also readily visualized. These ...

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      Mentions: Fernando Alfonso
    11. New Insights on Plaque Erosion and Calcified Nodules “Seeing Is Believing”

      New Insights on Plaque Erosion and Calcified Nodules “Seeing Is Believing”

      Plaque erosion (PE) and calcified nodules (CN) have been classically described in pathological studies as causes of acute coronary syndromes (ACS) ( 1 ). However, until very recently, the diagnosis of these entities in the clinical setting has remained largely elusive ( 1 ). In this regard, the study of Jia et al. 2 , using optical coherence tomography (OCT) for the diagnosis of PE and CN, is of major clinical interest and raises several important issues. First, the investigators considered that OCT might provide a “definitive” diagnosis of PE when fibrous cap disruption is excluded and a thrombus overlying an “intact” plaque is visualized ...

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    1-13 of 13
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    1. (13 articles) Fernando Alfonso
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    New Insights on Plaque Erosion and Calcified Nodules “Seeing Is Believing” Treatment of In-Stent Restenosis With Bioresorbable Vascular Scaffolds: Optical Coherence Tomography Insights Kounis Syndrome: Optical Coherence Tomography Findings Phantom Stent Thrombosis: Intracoronary Imaging Insights In-Stent Restenosis Caused by a Calcified Nodule: A Novel Pattern of Neoatherosclerosis Coronary Pleating Mimicking Coronary Ruptures, Dissections, and Thrombi on Optical Coherence Tomography Coronary Pleating Mimicking Coronary Ruptures, Dissections, and Thrombi on Optical Coherence Tomography Mother-and-child catheter-facilitated optical coherence tomography: A novel approach to improve intracoronary imaging Multifaceted Presentation of Recurrent Spontaneous Coronary Artery Dissection Angiography and Optical Coherence Tomography Findings Coronary artery aneurysm formation following implantation of a bioresorbable vascular scaffold for in-stent restenosis Optical coherence tomography angiography (OCTA) findings in Serpiginous Choroiditis Changes in retinal layer thickness with maturation in the dog: an in vivo spectral domain - optical coherence tomography imaging study