Visualization of Recanalized Coronary Occlusion with Dissection by Optical Frequency Domain Imaging

Area of Science:

• Cardiovascular Imaging
• Interventional Cardiology
• Medical Diagnostics

Background:

• Positive stress myocardial perfusion imaging necessitates further investigation.
• Coronary computed tomography angiography (CCTA) is a common non-invasive imaging modality.
• Invasive coronary angiography remains the gold standard for coronary artery assessment.

Observation:

• A 43-year-old asymptomatic male presented with abnormal myocardial perfusion imaging.
• Coronary computed tomography angiography (CCTA) did not reveal significant coronary artery disease.
• Invasive coronary angiography identified a unique long lesion in the left anterior descending artery.

Findings:

• Optical frequency domain imaging (OFDI) detailed a recanalized occlusion with coronary dissection.
• OFDI provided high-resolution, 3D in vivo imaging of complex intraluminal morphology.
• The findings suggest OFDI complements invasive angiography in complex coronary anatomy.

Implications:

• OFDI enhances the diagnostic capabilities for intricate coronary artery lesions.
• This case highlights the limitations of CCTA in specific complex coronary anatomies.
• Accurate intraluminal morphology assessment is crucial for guiding interventional cardiology procedures.