Journal Information
Vol. 39. Issue 7.
Pages 409-410 (July 2020)
Share
Share
Download PDF
More article options
Vol. 39. Issue 7.
Pages 409-410 (July 2020)
Image in Cardiology
Open Access
Looking in the mirror: An unusual optical coherence tomography image
Olhando para o espelho: uma tomografia de coerência ótica com uma imagem invulgar
Visits
2066
Patrícia Marques-Alvesa,b,
Corresponding author
pat.marques.alves@gmail.com

Corresponding author.
, Luís Leitea,b, Vítor Matosa, Lino Gonçalvesa,b
a Department of Cardiology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
b Faculty of Medicine, University of Coimbra, Coimbra, Portugal
This item has received

Under a Creative Commons license
Article information
Full Text
Download PDF
Statistics
Figures (1)
Full Text

A 75-year-old male underwent primary angioplasty of a subocclusive proximal to medial left anterior descending artery (LAD) stenosis, involving the origin of the first diagonal (D1). A provisional stenting technique was used, with two guidewires in the distal LAD and D1 and implantation of 3 mm×30 mm and 2.75 mm×28 mm drug-eluting stents (DES) in the LAD. Withdrawal of the jailed D1 guidewire caused a deep intubation of the guide catheter into the LAD. The subsequent angiogram was notable for a suspicious haziness proximal to the stents (Figure 1A, arrow). We decided to perform optical coherence tomography (OCT) of the LAD. However, the catheter did not pass further than the proximal segment, showing a conspicuous circular image (Figure 1B). Meanwhile, the intravascular ultrasound catheter was able to progress and did not show the image, only malapposed struts. Angioplasty proximal to the previous stents was performed with implantation of a 3.5 mm×18 mm DES, with a good final angiographic result (Figure 1C). In subsequent OCT images the circular image had disappeared.

Figure 1.

(A) Angiography showing a suspicious haziness proximal to the stents (arrow); (B) optical coherence tomography image of the proximal left anterior descending artery (proximal to the stent), with a suspicious circular image; (C) final angiographic result, after angioplasty with a 3.5 mm×18 mm drug-eluting stent proximal to the previous stents.

(0.18MB).

We postulate that the intubation of the guide catheter during retrieval of the jailed guidewire damaged the proximal stent struts. Thus, the circular OCT image was of the OCT catheter itself, which was folded by attempts to pass the catheter through the damaged stent. Our case illustrates an unusual image that can lead to uncertainties during OCT-guided angioplasty. The report of this peculiarity could help the interpretation of doubtful OCT images obtained in daily practice in the cath lab.

Conflicts of interest

The authors have no conflicts of interest to declare.

Copyright © 2020. Sociedade Portuguesa de Cardiologia
Idiomas
Revista Portuguesa de Cardiologia (English edition)
Article options
Tools
en pt

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos

By checking that you are a health professional, you are stating that you are aware and accept that the Portuguese Journal of Cardiology (RPC) is the Data Controller that processes the personal information of users of its website, with its registered office at Campo Grande, n.º 28, 13.º, 1700-093 Lisbon, telephone 217 970 685 and 217 817 630, fax 217 931 095, and email revista@spc.pt. I declare for all purposes that the information provided herein is accurate and correct.