Case

Spontaneous Recanalization of a Coronary Artery Following Thrombotic Occlusion. In Vivo Demonstration With Optical Coherence Tomography

- Operator : Jin man Cho

Spontaneous Recanalization of a Coronary Artery Following Thrombotic Occlusion. In Vivo Demonstration With Optical Coherence Tomography
- Operator: Jin man Cho, MD
Clinical Information
- Relevant clinical history and physical exam:
A 50 year old man who suffered a left middle cerebral artery embolic stroke 1 month previously, was referred by a neurologist for an abnormal ECG (Figure 1). He denied any history of chest pain.

- Relevant test results prior to catheterization:
Echocardiography showed akinesis of the anteroapical left ventricular wall without obvious mural thrombus and an ejection fraction of 45%. There was no evidence of an intracardiac shunt.

- Relevant catheterization findings:
Coronary angiography was performed, which revealed irregularly shaped linear filling defects in the mid left anterior descending artery (LAD) with TIMI flow grade 3 (Figure 2).

Interventional Management

- Procedural step:
Optical coherence tomography (OCT)1 performed within this region showed multiple channels surrounding a larger central lmen (Figure 3A, arrowheads). The channels were seen to communicate both with each other and the larger central lumen (Figure 4, A-D). Proximally and distally they converged into a single lumen (Figure 3B). Some residual thrombus was still visualized within the smaller channels (Figure 3A, arrow)

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