scholarly journals Subacute Drug-Eluting Stent Thrombosis Caused by Stent Underexpansion: Evaluation by Optical Coherence Tomography

2011 ◽  
Vol 2011 ◽  
pp. 1-3
Author(s):  
Roberto Martín-Reyes ◽  
Santiago Jiménez-Valero ◽  
Felipe Navarro ◽  
Raúl Moreno
Keyword(s):  
Optical Coherence Tomography ◽  
Stent Thrombosis ◽  
Drug Eluting Stent ◽  
Optical Coherence ◽  
Circumflex Artery ◽  
St Segment Elevation ◽  
Left Circumflex Artery ◽  
Chronic Occlusion ◽  
St Segment ◽  
Drug Eluting

We present the case report of a patient presenting with ST segment elevation myocardial infarction due to a subacute drug-eluting stent trombosis within the proximal segment of the left circumflex artery (LCX). Six days before a total chronic occlusion was treated at the mid segment of the LCX by overlapping two drug-eluting stents. Optical coherence tomography (OCT) was helpful to demonstrate stent underexpansion of the overlaping segment as the main mechanism of early stent thrombosis. This case is illustrative about the potential role of OCT to identify the mechanisms of ST and thus guiding the PCI procedure. Moreover, our case shows the capability of the Imagewire to cross a severe stenosis due to stent underexpansion that could not be crossed by the IVUS catheter.

scholarly journals Frequency, Predictors, Distribution, and Morphological Characteristics of Layered Culprit and Nonculprit Plaques of Patients With Acute Myocardial Infarction

2020 ◽  
Vol 13 (10) ◽  
Author(s):  
Jiannan Dai ◽  
Chao Fang ◽  
Shaotao Zhang ◽  
Lulu Li ◽  
Yini Wang ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Optical Coherence Tomography ◽  
Morphological Characteristics ◽  
Optical Coherence ◽  
Circumflex Artery ◽  
St Segment Elevation ◽  
Left Circumflex Artery ◽  
St Segment ◽  
The Right

Background: Subclinical atherothrombosis and plaque healing may lead to rapid plaque progression. The histopathologic healed plaque has a layered appearance when imaged using optical coherence tomography. We assessed the frequency, predictors, distribution, and morphological characteristics of optical coherence tomography layered culprit and nonculprit plaques in patients with acute myocardial infarction. Methods: A prospective series of 325 patients with acute myocardial infarction underwent optical coherence tomography imaging of all 3 native coronary arteries. Layered plaque phenotype had heterogeneous signal-rich layered tissue located close to the luminal surface that was clearly demarcated from the underlying plaque. Results: Layered plaques were detected in 74.5% of patients with acute myocardial infarction. Patients with layered culprit plaques had more layered nonculprit plaques; and they more often had preinfarction angina, ST-segment–elevation myocardial infarction, higher low-density lipoprotein cholesterol, and absence of antiplatelet therapy. Layered plaques tended to cluster in the proximal segment of the left anterior descending artery and left circumflex artery but were more uniformly distributed in the right coronary artery. As compared with nonlayered plaques, layered plaques had greater optical coherence tomography lumen area stenosis at both culprit and nonculprit sites. The frequency of layered plaque phenotype ( P =0.038) and maximum area of layered tissue ( P <0.001) increased from nonculprit thin-cap fibroatheromas to nonculprit ruptures to culprit ruptures. Conclusions: Layered plaques were identified in 3-quarters of patients with acute myocardial infarction, especially in the culprit plaques of patients with ST-segment–elevation myocardial infarction. Layered plaques had a limited, focal distribution in the left anterior descending artery, and left circumflex artery but were more evenly distributed in the right coronary artery and were characterized by greater lumen narrowing at both culprit and nonculprit sites. Graphic Abstract: A graphic abstract is available for this article.

scholarly journals A case of left circumflex artery stenosis involving ST segment depression in multiple leads with ST elevation in lead augmented vector right

2019 ◽  
Vol 6 (7) ◽  
pp. 2598
Author(s):  
C. P. Karunadas ◽  
Cibu Mathew
Keyword(s):  
Beta Blockers ◽  
Coronary Intervention ◽  
Drug Eluting Stent ◽  
Circumflex Artery ◽  
St Segment Elevation ◽  
Left Circumflex Artery ◽  
St Depression ◽  
St Segment ◽  
Lead Avr ◽  
St Elevation

Electrocardiography (ECG) patterns of ST-segment elevation in lead aVR with or without diffuse ST segment depression may predict either left main coronary artery or triple vessel stenosis. Here, we have presented the case of a 56-year-old female involving such an ECG pattern with ST-segment depression in more than eight leads and ST Segment elevation in lead aVR, however, showing stenosis of the mid-segment of the left circumflex artery (LCX). She was scheduled to undergo percutaneous coronary intervention with implantation of a drug-eluting stent with respect to mid LCX stenosis. The patient was asymptomatic post procedure and was discharged on beta blockers. To conclude, the ECG pattern of ST depression in multiple leads with ST-elevation in aVR lead can occur in LCX obstruction as well. 

scholarly journals In Vivo Optical Coherence Tomography of Very Late Drug-Eluting Stent Thrombosis Compared With Late In-Stent Restenosis

2012 ◽  
Vol 76 (2) ◽  
pp. 390-398 ◽  
Author(s):  
Shinichiro Miyazaki ◽  
Yoshikazu Hiasa ◽  
Takefumi Takahashi ◽  
Yudai Yano ◽  
Tomoko Minami ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Stent Thrombosis ◽  
Drug Eluting Stent ◽  
Optical Coherence ◽  
Stent Restenosis ◽  
Drug Eluting ◽  
In Stent Restenosis

scholarly journals Mechanisms of Very Late Drug-Eluting Stent Thrombosis Assessed by Optical Coherence Tomography

Circulation ◽  
2016 ◽  
Vol 133 (7) ◽  
pp. 650-660 ◽  
Author(s):  
Masanori Taniwaki ◽  
Maria D. Radu ◽  
Serge Zaugg ◽  
Nicolas Amabile ◽  
Hector M. Garcia-Garcia ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Stent Thrombosis ◽  
Drug Eluting Stent ◽  
Optical Coherence ◽  
Drug Eluting
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