Author + information
- Received May 27, 2014
- Revision received July 2, 2014
- Accepted July 5, 2014
- Published online December 1, 2014.
- Omar Gómez-Monterrosas, MD∗,
- Ander Regueiro, MD∗,
- Alejandro Santos, MD†,
- Shuji Otsuki, MD∗,
- Giancarla Scalone, MD‡,
- Diego Fernández-Rodríguez, MD∗ and
- Manel Sabaté, MD, PhD∗∗ ()
- ∗Cardiology Department, Thorax Institute, Hospital Clínic, Institut D’Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
- †Cardiology Department, Hospital Dr. Domingo Luciani, Caracas Venezuela
- ‡Cardiology Department, Catholic University of Sacred Heart, Rome, Italy
- ↵∗Reprint requests and correspondence:
Dr. Manel Sabaté, Cardiology Department, Thorax Institute, Hospital Clínic, The August Pi i Sunyer Biomedical Research Institute (IDIBAPS), University of Barcelona, Villarroel 170, 08036, Barcelona, Spain.
A 29-year-old man underwent coronary angiography after non–ST-segment elevation myocardial infarction. He was a current smoker and did not have any other relevant medical history. Coronary angiography revealed a lesion with contrast filling defect and irregular lumen border at the mid-segment of the left anterior descending artery (Figures 1A and 1B). Coronary distal flow was partially preserved. Optical coherence tomography (OCT) was performed to characterize the lesion. Lesion was crossed with a BMW Coronary guidewire (Abbott Vascular, Abbott Park, Illinois) and placed in the distal left anterior descending artery. An OCT catheter (C7-XR, Dragon Fly, LightLab, St. Jude Medical, St. Paul, Minnesota) was advanced easily into the distal segment of the left anterior descending artery. OCT imaging revealed multiple honeycomb-like channels and a subocclusive stenosis of the true lumen (Figures 1C to 1F, Online Video 1). After OCT imaging, an everolimus-eluting Absorb bioresorbable vascular scaffold (BVS), 3 × 18 mm (Abbott Vascular, Santa Clara, California) was implanted, obtaining a satisfactory final angiographic result (Figures 2A and 2B). OCT revealed an adequate expansion and apposition of the BVS with persistent abluminal hematoma sealed by the scaffold at the distal segment (Figures 2C to 2F, Online Video 2). Three months later, the patient remained asymptomatic.
OCT images have provided new insights into evolving thrombotic lesions, and to further evaluate intracoronary and recanalized thrombotic lesions (1). Recanalized thrombi are characterized by multiple small channels divided by thin septa communicating with each other. BVS may be a therapeutic alternative in the percutaneous treatment of these injuries, especially in young patients.
For accompanying videos, please see the online version of this article.
The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received May 27, 2014.
- Revision received July 2, 2014.
- Accepted July 5, 2014.
- American College of Cardiology Foundation