Atlas of Coronary Intravascular Optical Coherence Tomography by Annapoorna Kini Jagat Narula Yuliya Vengrenyuk & Samin Sharma

Author:Annapoorna Kini, Jagat Narula, Yuliya Vengrenyuk & Samin Sharma
Language: eng
Format: epub
Publisher: Springer International Publishing, Cham

3.2 Case 1. Rotational Atherectomy of a Proximal LAD Lesion: Grinding the Lesion (Figs. 3.1 and 3.2, Videos 3.1 (Part I), 3.1 (Part II), 3.2, and 3.3)

Fig. 3.1A 47-year-old male, a smoker with hyperlipidemia and hypertension with a positive single-photon emission computed tomography myocardial perfusion imaging (SPECT-MPI) and LAD stenosis on coronary computed tomography angiography (CTA) and was found to have stable angina. The coronary angiogram showed a 70–80% stenosis of the proximal LAD with calcification (a1 , arrow). OCT imaging confirmed the presence of severe calcification at the site of stenosis with a minimal lumen area of 1.9 mm2 (b1 , asterisk) and proximal to the MLA with a total length of 14 mm (c1 , dotted line). Calcified plaque was ablated by rotational atherectomy (RA) using a 1.75-mm burr for 60 s. OCT pullback performed after RA demonstrated a 32% increase in the minimal lumen area (b1 vs. b2), uniform plaque modification with a smooth cylindrical shape of the lumen (c2), and small intimal cuts (b2)

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