Stent procedure complicated by thrombus formation distal to the lesion within a muscle bridge

Myocardial bridging on coronary CTA: An innocent bystander or a culprit in myocardial infarction?

“…51,52 In addition, it has been reported that endothelium-mediated vasodilators enhance vasoconstriction at the myocardial bridge, indicating endothelial dysfunction in the bridged coronary artery segment. 53 This endothelial dysfunction may stimulate coronary vasospasm, platelet aggregation, and thrombus formation either within or proximal to the myocardial bridge. 47 The degree of systolic compression appears to be of clinical importance.…”

Rescue coronary angioplasty in a patient with acute myocardial infarction and myocardial bridge

“…Ge et al 2 , in a compa-rative study of coronary angiography with intracoronary ultrasound in 14 patients with MB, found that an atherosclerotic plaque was present in 12 patients (86%) in the proximal portion of the MB and that the distal portion was normal. MB may alter the distribution of physical forces against the arterial wall, thus playing a role in the development of atherosclerosis in the proximal portion 2,15,16 .…”

“…This implies that the impairment of blood flow and the high proximal stress may play a role in the development of atherosclerosis in this segment of the vessel 15 . Morales et al 7 performed necropsy in 3 patients with sudden death and MB in the ADA and found an atheromatous lesion of the proximal segment in two of these patients.…”

“…More recently, with the emergence of angioplasty and of coronary stenting, a series of studies describing successful interventions in MB have been reported 1,9,10,15 . Most reports are more related to the use of stents 1,9,15 , as they are correlated with a better immediate outcome.…”

CT coronary angiography in the investigation of chest pain — Beyond coronary artery atherosclerosis; A pictorial review

“…Although bridged segments are spared from atherosclerosis, there is evidence to suggest there is endothelial dysfunction at the site of the bridge [55] and atherosclerosis may be more frequent in segments proximal to bridging [56,57].…”