Detection of Post-Stent Medial Dissection and White Thrombus Using Hybrid IVUS OCT Imaging may Help Guide Management
Natali Sorajja1, Khady N Fall2, Jeffrey W Moses2
1Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, USA.
Insights
Percutaneous coronary intervention (PCI) for right coronary artery lesions can reveal dissections. Intravascular imaging guided treatment decisions, successfully managing dissections without complications.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Medical Imaging
Background:
- Percutaneous coronary intervention (PCI) is a common treatment for coronary artery disease.
- Accurate lesion assessment is crucial for successful PCI outcomes.
- Intravascular imaging modalities like IVUS and OCT enhance visualization during PCI.
Abstract:
We present a 66-year-old undergoing ostial-to-mid right coronary artery (RCA) percutaneous coronary intervention (PCI) lesion proximal to an existing stent in the mid-to-distal segment. The patient underwent PCI, with intravascular imaging using the Novasight Hybrid IVUS OCT (Conavi, Toronto, CA) which revealed a proximal edge dissection and distal dissection involving the media on OCT, less discernable on IVUS, which required an additional distal stent. Proximally, based on OCT minimal luminal area (MLA) measurements of the dissection, the size of the dissection flap and lack of involvement of the media, a stent was not placed. The patient did well with no periprocedural complications.
Related Concept Videos
Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies
Venous Thrombosis III: Interprofessional Care
Imaging Studies for Cardiovascular System V: CT
Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT
