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Sigmund Freud revolutionized our understanding of dreams by proposing that they are a window into the unconscious mind. According to Freud, dreams are not mere stories our minds create while we sleep but are profoundly meaningful narratives about our hidden desires and fears. He introduced two key concepts: manifest content and latent content. The manifest content is the actual content and imagery of the dream — what we remember when we wake up. The latent content, however, represents the...
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Diligence diverts a daymare.

Sriram Veeraraghavan1, Bharath Raj Kidambi2

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Summary

Optical coherence tomography (OCT)-guided angioplasty effectively treated calcific stenosis in a patient with complex cardiovascular conditions. This technique provided detailed imaging for precise intervention in the left anterior descending artery (LAD) and obtuse marginal (OM) arteries.

Keywords:
diligenceiatrogenic left main dissectionintramural hematomaoptical coherence tomographytortuous lesion

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Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Medical Imaging

Background:

  • Complex coronary artery disease necessitates advanced imaging for effective treatment.
  • Calcific stenosis poses a significant challenge in percutaneous coronary interventions.
  • Optical coherence tomography (OCT) offers high-resolution imaging for complex lesions.

Observation:

  • A 73-year-old female patient presented with diabetes, hypertension, and non-ST elevation myocardial infarction.
  • The patient had calcific stenosis in the mid-left anterior descending artery (LAD) and mid-obtuse marginal (OM) artery.
  • A tortuous anatomy of the OM artery complicated the lesion.

Findings:

  • Successful OCT-guided angioplasty was performed for the calcific stenosis in the LAD and OM arteries.
  • OCT provided critical anatomical and morphological information for procedural guidance.
  • The intervention addressed the complex, calcified lesions in a challenging vascular bed.

Implications:

  • OCT-guided angioplasty is a valuable tool for managing complex calcific coronary artery disease.
  • High-resolution imaging improves procedural success rates and patient outcomes.
  • This case highlights the utility of OCT in tortuous vessels and severe stenosis.