• Fei-Fei Zhang, Yi Dang, Qing-Qing Hao, Yue-Tao Xie, Shu-Ren Li, and Xiao-Yong Qi.
• Department of Cardiology Center, Hebei General Hospital, Shijiazhuang, Hebei Province, China.
• Medicine (Baltimore). 2018 Dec 1; 97 (50): e13669.

RationalePrimary percutaneous coronary intervention (PPCI) with immediate stenting provides effective revascularization. While the risks of no-reflow, stent thrombosis, stent undersizing, and malapposition reduced the benefits in patients with high burden thrombosis. Intravascular imaging, especially optical coherence tomography (OCT), offers potential in optimization of percutaneous coronary intervention.Patient ConcernsA 51-year-old male underwent coronary angiography (CAG) due to chest pain with minimal ST-segment depression of the electrocardiogram.DiagnosesUrgent CAG revealed burden thrombus in the mid left anterior descending coronary artery (LAD) with TIMI grade I distal flow.InterventionsAfter aspiration thrombectomy, OCT was used to evaluate the target lesion of non-ST-segment elevation myocardial infarction (NSTEMI) and conservative treatment without stent implantation was selected.OutcomesCAG repeated 1 month after PPCI revealed TIMI grade III blood flow in LAD and only minimal stenosis in the target lesion. OCT showed a cavity formation due to plaque rupture and MLA increased after thrombus dissolution. Follow-up was uneventful at 6 months.LessonsOCT may be useful imaging modality to identify the characteristic of culprit lesion of acute myocardial infarction and subsequently guide individual treatment.

23 keywords...

hide…