Honeycomb-like structure in spontaneous recanalized coronary thrombus demonstrated by serial angiograms: a case report
| Autor: | Yasuhiro Ishii, Mitsuru Kahata, Natsuko Satomi, Masato Otsuka |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Case Reports Myocardial ischaemia Left coronary artery Internal medicine medicine.artery Intravascular ultrasound Occlusion Case report medicine AcademicSubjects/MED00200 cardiovascular diseases Coronary heart disease (incl. Cardiac Intervention) Thrombus Atherosclerotic plaque medicine.diagnostic_test business.industry Percutaneous coronary intervention medicine.disease Thrombosis Recanalized thrombus Right coronary artery Conventional PCI Cardiology Cardiology and Cardiovascular Medicine business Honeycomb-like structure |
| Zdroj: | European Heart Journal: Case Reports |
| ISSN: | 2514-2119 |
| Popis: | Background The honeycomb-like structure (HLS) is a rare cause of myocardial ischaemia characterized by multiple communicating channels divided by thin septa. The aetiology of this specific structure remains speculative. Case summary A 55-year-old man was admitted due to worsening effort angina during the previous 2 months. Diagnostic coronary angiography revealed occlusion of the distal right coronary artery (RCA) with good collateral flow from the left coronary artery. We considered this lesion as a recent total occlusion, and planned a percutaneous coronary intervention (PCI). At the time of PCI, 7 days after admission, an angiogram showed a spontaneous recanalization of the occlusive RCA. Intravascular ultrasound (IVUS) depicted a HLS at the recanalized lesion, including atherosclerotic stenosis. We managed these lesions with drug-eluting stents. Discussion A recanalized thrombus may manifest as a HLS. In this case, the patient suffered from worsening effort angina during the previous 2 months, we confirmed a spontaneous recanalization of the occluded coronary lesion by serial angiographic images, and observed HLS adjacent to the atherosclerotic attenuated plaque by using high-resolution IVUS. Recanalized organizing thrombus is considered an entity of HLS. However, all previous studies on the HLS in vivo have detected the structure in an already recanalized state. Therefore, the aetiology remained speculative and evidence has been indirect. This present case demonstrates that recanalized atherosclerotic thrombosis might be one of the causes of HLS. |
| Databáze: | OpenAIRE |
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