Early Healing of Spontaneous Coronary Artery Dissection Confirmed by Optical Coherence Tomography

Our image series show the use of intravascular ultrasound (IVUS) and optical coherence tomography (OCT) in the diag- nosis and treatment of a 52-year-old male who was admitted to our hospital because of inferior ST-segment-elevation myocardial infarction. An emergent coronary angiogram showed the total occlusion at the proximal site of the right coronary artery (RCA). IVUS revealed false lumen and intramural hematoma, as well as intimal tear at the proximal site of RCA, diagnosed as a spontaneous coronary artery dissection (SCAD). A drug-eluting stent was implanted over the intimal tear at the proximal site of the RCA. Twenty-eight days later, OCT demonstrated completely healed SCAD with TIMI 3 flow. OCT can visualize the 3-layered construction of the vessel wall and accurately diagnose SCAD. This image provides a presentation of early healing of acute SCAD confirmed by OCT, and might help in the management of acute SCAD.