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Updated: Jan 10, 2026

Optical Coherence Tomography Based Biomechanical Fluid-Structure Interaction Analysis of Coronary Atherosclerosis Progression
Published on: January 15, 2022
Unique Intravascular Ultrasound and Optical Coherence Tomography Features of Multivessel Coronary Stenosis in
Keita Tashiro1, Ryutaro Ikegami1, Makoto Hoyano1
1Department of Cardiovascular Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
Background:
Pseudoxanthoma elasticum (PXE) is a rare disease resulting from ABCC6 gene mutations; it causes elastic fiber calcification with unclear arterial stenosis mechanisms.
Case Summary:
A 60-year-old man with PXE developed multivessel coronary stenosis despite low atherosclerotic risk. Coronary computed tomography demonstrated noncalcified stenosis in all vessels, intravascular ultrasound (IVUS) showed concentric high-intensity lesions with mixed acoustic shadowing, and optical coherence tomography (OCT) indicated thin, sheet-like calcifications with low-intensity heterogeneous tissue. Guidance through IVUS/OCT imaging contributed to successful percutaneous coronary intervention.
Discussion:
PXE demonstrates stenotic mechanisms distinct from conventional atherosclerosis. Stenosis develops as a result of tissue thickening caused by calcification-induced fragmentation and repair. To our knowledge, no previous reports have evaluated coronary stenosis in PXE using both IVUS and OCT.
Take-Home Messages:
Patients with PXE may develop significant coronary stenosis despite low atherosclerotic risk, requiring early cardiovascular evaluation. Combined IVUS/OCT imaging reveal unique stenotic findings resulting from elastic fiber calcification.
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