Crop Circles in Optical Coherence Tomography

A 57-year-old woman with a history of idiopathic thrombo- cytopenia presented with chest pain and inferior ST-segment elevation myocardial infarction following percutaneous coronary intervention to a distal right coronary artery (RCA) stenosis. A right femoral artery angiogram showed an acute stent thrombosis. After blood flow was restored with intracoronary thrombectomy and balloon angioplasty, optical coherence tomography (OCT) was performed using DragonFly Optis (Abbott Vascular). Unfortunately, it was difficult to advance the catheter beyond the stented segment. On review of the image, there were 2 circular figures resembling “crop circles” extending proximally for several frames (Figure 1).