Optical Coherence Tomography-guided Intervention in STEMI Patients with Normal Looking Coronaries

Area of Science:

• Cardiovascular Imaging
• Interventional Cardiology

Background:

• Optical coherence tomography (OCT) is an advanced intracoronary imaging technique.
• Percutaneous coronary intervention (PCI) benefits from precise luminal and plaque characterization.

Observation:

• Two cases of acute ST elevation myocardial infarction (STEMI) presented with minimal coronary artery narrowing (<30%) on angiography.
• Standard angiography indicated TIMI III flow, suggesting non-obstructive disease.

Findings:

• OCT imaging provided superior resolution for detailed plaque assessment in both STEMI cases.
• The high-resolution imaging facilitated appropriate management decisions despite minimal angiographic narrowing.

Implications:

• OCT can be crucial for guiding PCI in complex STEMI cases with non-obstructive coronary lesions.
• Accurate plaque characterization by OCT improves treatment strategies and patient outcomes in myocardial infarction.