Author + information
- Received January 24, 2011
- Accepted February 3, 2011
- Published online October 11, 2011.
A 32-year-old man presented to the emergency department with stuttering chest discomfort. Electrocardiography confirmed transient ST-segment elevations in the inferior leads, which rapidly subsided in the following minutes. By coronary angiography, we found a right dominant coronary system and single-vessel coronary artery disease with haziness in the distal segment of the right coronary artery just before the crux and accompanying TIMI (Thrombolysis In Myocardial Infarction) flow grade 3 (Online Video 1). The region of interest in between the 2 vertical lines on the angiogram was scanned by optical coherence tomography (A), which demonstrated intimal thickening in the proximal portion and a significant load of mural, predominately white thrombus in a region of focal, eccentric lipid-rich plaque formation (Online Video 2). No plaque rupture was visible. On the longitudinal reconstruction of the optical coherence tomography acquisition, a, b, and c indicate the position of the cross-sections C, D, and E. Three-dimensional reconstruction using Intage Realia software (Knowledge Graphics Technology, Cybernet, Tokyo, Japan) illustrates the eccentric thrombus (*) stretching out over the floor of the vessel wall (B, arrowhead). Optical coherence tomography is an invasive imaging tool enabling endoluminal scanning of coronary arteries with high resolution and in 3 dimensions.
- Received January 24, 2011.
- Accepted February 3, 2011.
- American College of Cardiology Foundation