Is every woven coronary artery benign? Case report

Bi, Xia; Yang, Hongmei; Liu, Li; Wang, Qingsheng

doi:10.1007/s11739-018-1923-x

Cited by 6 publications

(6 citation statements)

References 7 publications

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“…e diagnosis of WCA made merely by CAG in early reports was certainly arbitrary and not verifiable. Furthermore, the OCT images provided by recent case reports challenged the diagnosis of the "WCA anomaly" since they showed an integrated wall structure of a previously normal RCA instead of separate vessel structures, and instead, thin channels were present [5,6,10]. Such an OCT appearance was also revealed in a braid-like RCA of a case of Kawasaki disease [24].…”

Section: Discussionmentioning

confidence: 99%

“…In previously documented case reports, as shown in Table 5, the most frequent diagnosis for such a braid-like coronary artery was a WCA anomaly [1][2][3][4][5][6][7][8][9][10]12,[15][16][17]. However, for most of these cases, we may need a different diagnosis.…”

Section: Discussionmentioning

confidence: 99%

“…[1] Since then, a few isolated cases of WCA had been reported. However, the majority of these reports were just based on CAG, and some have been found to be associated with atherosclerosis, chronic ischemia, acute coronary syndrome, and even cardiac arrest [2][3][4][5][6][7][8][9][10][11][12]. e diversity of the manifestations of such lesions has caused great confusion about the diagnosis of WCA as well as the treatment strategy.…”

Section: Introductionmentioning

confidence: 99%

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Differential Diagnosis, Clinical Characteristics, and Interventions of Braid-Like Coronary Artery: Case Series Analysis Based on Optical Coherence Tomography

Leng

Wang

Liu

et al. 2020

Journal of Interventional Cardiology

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Aim. Based on optical coherence tomography (OCT), we aimed to determine the diagnosis, clinical characteristics, and interventions of braid-like coronary arteries, which are rare and tend to be diagnosed as a woven coronary artery (WCA) anomaly. Methods and Results. We identified braid-like lesions on coronary angiography (CAG) in 7 patients (6 men; median age 47 years; age range 26 to 57 years). All patients were heavy smokers. Four patients were diagnosed with an old myocardial infarction and the other 3 with unstable angina. The braid-like lesions were located in the left anterior descending arteries in 2 patients and in the right coronary arteries in the other 5. TIMI grade 2 flow was observed in all involved vessels. OCT findings of all lesions were consistent with recanalization of organized thrombi, which consisted of septa that divided the lumen into multiple small cavities communicating with each other. No separate three-layered structure could be defined. Based on the significance of the stenosis and its related symptoms, drug-eluting stents were implanted in all of the lesions. All patients experienced symptomatic improvement after the intervention and were followed up event-free for 12 months. Conclusions. Braid-like coronary arteries are likely to undergo recanalization of organized thrombi rather than WCA according to our OCT findings. The majority of cases affect men who smoke heavily. Percutaneous stent implantation may be beneficial in selected patients when feasible.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Differential Diagnosis, Clinical Characteristics, and Interventions of Braid-Like Coronary Artery: Case Series Analysis Based on Optical Coherence Tomography

Leng

Wang

Liu

et al. 2020

Journal of Interventional Cardiology

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“…Cross-communication is a key feature in distinguishing WCAA and recanalized thrombus. On OCT, the recanalized thrombus has been described as a “lotus-root” or “swiss-cheese” appearance due to the presence of multiple interconnected channels within the thrombus [ 20 , 21 ]. This is unlike a congenital woven anomaly, which has no cross-communication between channels [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

“…Asymptomatic patients should be kept under observation especially if there is no evidence of ischemia. However, once symptoms such as angina are noted, patients must undergo further testing to confirm ischemia before deciding upon interventions such as surgical or percutaneous revascularization [ 21 – 23 ]. A method that can be helpful in deciding upon an intervention is the usage of fractional flow reserve (FFR) [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

Woven Coronary Artery Anomaly: An Incidental Finding and Literature Review

Bamousa

Sbitli

Mohamed

et al. 2022

Case Reports in Cardiology

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Woven coronary artery anomaly is a rare description of an epicardial vessel segment that divides into multiple intertwining segments with eventual convergence of the distal vessel. We present our case, a 57-year-old male with an incidental woven coronary artery anomaly found during work-up investigations for a possible lung transplant, and we conduct a literature review on woven anomaly cases reported from 1988 to 2021 and provide a thorough analysis of its diversified clinical presentation. Imaging identification and various treatment modalities are also discussed.

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Optical coherence tomography-assisted interventional treatment of a woven coronary artery: a case report

Wei

Zhang

Gao

2023

BMC Cardiovasc Disord

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Abstracts Background A woven coronary artery is a rare feature on coronary angiography. Distinguishing woven-like change and recanalization of an occluded artery is difficult. Case presentation A 59-year-old man was admitted to the hospital for chest tightness. Coronary angiography showed a woven coronary artery at the middle segment of the left anterior descending branch (LAD). The middle segment of the right coronary artery (RCA) exhibited 99% occlusion. A 3.5 × 26-mm drug-eluting stent was implanted in the middle segment of the RCA. One week later, we examined the LAD using optical coherence tomography (OCT). Considering the patient’s medical history and the results of OCT, a 2.7 × 38-mm drug-eluting stent was inserted into the LAD. Re-examination by OCT indicated that the stent was well attached to the wall, with no dissection at the edge of the stent. Antiplatelet therapy and statin-based plaque stabilization were continued. No obvious abnormality was found during follow-up one year later. Conclusions OCT can help distinguish woven-like change and recanalization of an occluded coronary artery. The evaluation and formulation of treatment strategies for a woven coronary artery are important.

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Is every woven coronary artery benign? Case report

Cited by 6 publications

References 7 publications

Differential Diagnosis, Clinical Characteristics, and Interventions of Braid-Like Coronary Artery: Case Series Analysis Based on Optical Coherence Tomography

Differential Diagnosis, Clinical Characteristics, and Interventions of Braid-Like Coronary Artery: Case Series Analysis Based on Optical Coherence Tomography

Woven Coronary Artery Anomaly: An Incidental Finding and Literature Review

Optical coherence tomography-assisted interventional treatment of a woven coronary artery: a case report

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