1. 1-5 of 5
    1. Rediscover a Missed Culprit Lesion with Optical Coherence Tomography in Acute Coronary Syndrome: a Simple Stationary Pullback Method

      Rediscover a Missed Culprit Lesion with Optical Coherence Tomography in Acute Coronary Syndrome: a Simple Stationary Pullback Method

      A 54-year-old male was admitted to the hospital due to severe chest pain. He suffered from diabetes mellitus for 20 years and was an ex-smoker. The 12 leads electrocardiography showed ST-segment elevation in inferior leads. High sensitivity troponin level was elevated, and underwent coronary angiography. The echocardiogram showed basal inferior hypokinesia with normal left ventricular systolic function. The coronary angiography demonstrated an insignificant stenosis with vague plaque ulceration at the proximal portion of right coronary artery ( Figure 1A , asterisk). The automatic motorized pullback of optical coherence tomography (OCT) was performed at 10 mm/sec with simultaneous injection of a contrast ...

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    2. Successful Culotte Stenting for Unprotected Left Main Trifurcation Disease: Insights from Optical Coherence Tomography

      Successful Culotte Stenting for Unprotected Left Main Trifurcation Disease: Insights from Optical Coherence Tomography

      A 41-year-old man presenting with new-onset effort angina was referred to our clinic. Angiography revealed a left main trifurcation lesion including significant stenosis in the unprotected left main coronary artery (ULMCA), ostial left anterior descending artery (LAD), ostial left circumflex artery (LCX) with grade 3 collateral flow from the right coronary artery, and diffuse ramus intermedius artery (RI) ( Supplementary Video 1 ). After an 8-French extra backup guiding catheter with a side hole was engaged into the left coronary artery via the right femoral approach, plain old balloon angioplasty (POBA) was performed from the ULMCA to LAD, LCX, and RI, respectively ...

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    3. Optical Coherence Tomography Findings of Non-ST Elevation Myocardial Infarction with Multivessel Disease

      Optical Coherence Tomography Findings of Non-ST Elevation Myocardial Infarction with Multivessel Disease

      A 48-year-old man with a history of current smoking presented to our department with sudden-onset chest pain at rest. Elevated high sensitivity troponin level led to urgent coronary angiography (CAG). CAG revealed intermediate stenosis with multiple linear filling defects in the mid right coronary artery (RCA) ( Figure 1A ). Cross-sectional ( Figure 1B-1D ) and longitudinal ( Figure 1F ) optical coherence tomography (OCT) demonstrated a honeycomb-like structure with multiple cavities of various size separated by tissue with high-signal intensity ( Supplementary Video 1 ). Three-dimensional OCT also showed multiple cavities communicating with true lumen ( Figure 1E , asterisks) and we concluded that this represented recanalized thrombus. Regarding ...

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    4. Optical Coherence Tomography: Defined Plaque Erosion after Removal of a Coronary Guidewire

      Optical Coherence Tomography: Defined Plaque Erosion after Removal of a Coronary Guidewire

      A 45-years-old male patient presented with a non-ST elevation myocardial infarction (MI). Coronary angiography revealed only mild luminal stenosis in the middle portion of the left anterior descending artery ( Figure 1 ). For evaluation of the culprit lesion of an acute MI (AMI), intravascular optical coherence tomography (OCT) was performed ( Figure 2A , Supplementary Video 1 ). A few cross-sectional OCT images at angiographically mildly stenotic segments showed a suspicious presence of an intracoronary thrombus adjacent to the acoustic shadow by the guidewire artifact ( Figure 2B-F ), leading to an undetermined cause of the pathomechanism of the AMI. Therefore, the guidewire was removed from ...

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    5. Optical Coherence Tomography-guided Treatment of Multiple Stent Fracture in Patients with Overlapping Drug-eluting Stents

      Optical Coherence Tomography-guided Treatment of Multiple Stent Fracture in Patients with Overlapping Drug-eluting Stents

      A 71-year-old man presented with exertional angina. Ten years ago, he had undergone treatment for myocardial infarction with two heterogeneous drug-eluting stents (DESs) in the right coronary artery (RCA): 4.0×30-mm Endeavor™ (Medtronic, Minneapolis, MN, USA) and 3.5×32-mm Taxus™ (Boston Scientific, Natick, MA, USA). Coronary angiography revealed intraluminal haziness in the middle of the previous RCA stent without significant in-stent restenosis ( Figure 1A ). However, magnified fluoroscopic images showed suspicious complete separation with displacement of the DES overlapping site ( Figure 1B ). Optical coherence tomographic (OCT) images showed multiple stent fractures with four gaps, confirmed on 3-dimensional (3D) reconstructed ...

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    1-5 of 5
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