Intravascular Images of Coronary Stenosis with Multiple Channels in a Patient with Antiphospholipid Syndrome: The Optical Coherence Tomography Findings

Ito, Shigenori; Hasuo, Takahiro

doi:10.2169/internalmedicine.56.7804

Cited by 7 publications

(5 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Each modality provided detailed information on the coronary artery lesion. As in our case, OCT findings of recanalized thrombi showed a “spider web” or “honeycomb” pattern [ 6 – 8 ]. Since the irregularity of the recanalized thrombotic lesion on coronary angiography was mild but contained multiple lumens, the guidewire could easily have aberrantly crossed into a small channel, making the guidewire difficult to pass through the lesion.…”

Section: Discussionsupporting

confidence: 53%

Difficult Wiring of a Recanalized Thrombotic Lesion in the Right Coronary Artery Analyzed with Optical Coherence Tomography

Niizeki¹,

Ikeno²,

Iwayama³

et al. 2018

Am J Case Rep

View full text Add to dashboard Cite

Patient: Male, 87Final Diagnosis: Recanalized thrombotic lesionSymptoms: Chest painMedication: —Clinical Procedure: GoodSpecialty: CardiologyObjective:Rare diseaseBackground:Recanalized thrombi are usually unrecognized in conventional coronary angiography. However, multiple channels have been observed in recanalized thrombotic lesions. Therefore, the wire apparently crosses the lesion in some difficult cases. We analyzed the cause of difficult wiring of a recanalized thrombotic lesion using optical coherence tomography (OCT).Case Report:An 87-year-old man with chest pain was admitted to our hospital. Coronary angiography showed significant stenosis of the proximal right coronary artery with irregular linear filling and haziness. Crossing of the wire for the lesion was very difficult but was achieved using a parallel wire technique. OCT clearly demonstrated multiple small channels which had ambiguous findings on angiography and intravascular ultrasound. These structures showed a honeycomb-like appearance suggests the recanalized thrombi. A drug-eluting stent was subsequently deployed to fully cover the entire lesion.Conclusions:OCT is useful to evaluate the accurate tissue characteristics of a recanalized thrombotic lesion. Because recanalized thrombi have multiple small channels and since there are some cases in which a part of the channel only flows into a side branch, it is necessary to carefully monitor wiring at the time of percutaneous coronary intervention.

show abstract

Section: Discussionsupporting

confidence: 53%

Difficult Wiring of a Recanalized Thrombotic Lesion in the Right Coronary Artery Analyzed with Optical Coherence Tomography

Niizeki¹,

Ikeno²,

Iwayama³

et al. 2018

Am J Case Rep

View full text Add to dashboard Cite

show abstract

“…A positive LAA, as in our patient, increases the risk of AMI by 5.5%, and the risk for angina pectoris by 2.7%. 8,9 Similarly, the IgG isotype of anticardiolipin (aCL) is strongly atherogenic and associated with worse cardiovascular outcomes, although this antibody was not present in our patient. In the end, all individual aPLs increase the risk for thrombosis and atherosclerosis.…”

Section: Discussionmentioning

confidence: 60%

Acute ST-elevation myocardial infarction in a young patient with antiphospholipid syndrome

González-Cordero

Ruiz-Rodríguez

Ramos-Parra

et al. 2019

SAGE Open Medical Case Reports

View full text Add to dashboard Cite

Acute coronary syndrome rarely occurs in young individuals and is seldomly associated with antiphospholipid syndrome. We report the case of a 26-year-old Hispanic man who presented with acute ST-elevation myocardial infarction and was treated with urgent percutaneous transluminal coronary angioplasty. He experienced stent thrombosis within 48 h of intervention and subsequently developed a left apical thrombus. Hypercoagulable state studies were obtained at admission and 12 weeks after the event establishing the diagnosis of antiphospholipid syndrome.

show abstract

“…The relative roles of coronary thrombosis and of coronary atherosclerosis in patients with APLS and/or SLE have not yet been thoroughly studied [21]. On the other hand, the issue of percutaneous coronary interventions (PCI) and CABG in patients with SLE and ACS needs further assessment because of equivocal data with regard to their appropriateness and effectiveness and increased associated risks [22].…”

Section: Discussionmentioning

confidence: 99%

Acute coronary syndrome leading to revision of a co-morbid condition in a young man with arthritis

Smiyan

Komorovsky

Tomashchuk³

2019

Reumatologia

View full text Add to dashboard Cite

Although patients with rheumatoid arthritis (RA) may have an increased incidence of cardiovascular events, the development of coronary artery disease and of myocardial infarction at young age is rather uncommon. Herein, we report a case of a 26-year-old man without classical cardiovascular risk factors, but with a 2-year history of RA, who experienced recurrent episodes of angina-like chest pain. His electrocardiogram showed ST-elevation and T-wave inversion in anterior chest leads, and the patient was sent for coronary angiography, which revealed multivessel coronary artery disease. Subsequently, the patient underwent coronary artery bypass grafting. Closer analysis of the patient’s history and of the laboratory findings led to revision of the diagnosis of RA: the patient was found to meet the classification criteria for systemic lupus erythematosus. Pitfalls of the classification criteria and the impact of the revised diagnosis on the patient’s care are discussed.

show abstract

Intravascular Images of Coronary Stenosis with Multiple Channels in a Patient with Antiphospholipid Syndrome: The Optical Coherence Tomography Findings

Cited by 7 publications

References 23 publications

Difficult Wiring of a Recanalized Thrombotic Lesion in the Right Coronary Artery Analyzed with Optical Coherence Tomography

Difficult Wiring of a Recanalized Thrombotic Lesion in the Right Coronary Artery Analyzed with Optical Coherence Tomography

Acute ST-elevation myocardial infarction in a young patient with antiphospholipid syndrome

Acute coronary syndrome leading to revision of a co-morbid condition in a young man with arthritis

Contact Info

Product

Resources

About