Utilidad de técnicas de imagen en la valoración de la enfermedad coronaria - Tomografía de coherencia óptica

Echeverri, Natalia; Sibbald, Matthew; Sheth, Tej

doi:10.1016/j.rccar.2019.04.010

Cited by 1 publication

(3 citation statements)

References 21 publications

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“…Although coronary angiography is the gold standard technique to assess coronary artery disease and to perform percutaneous revascularization procedures, evaluating a three-dimensional structure with a two-dimensional image has its limitations 1 , 5 with an important interobserver variability, even when quantitative coronary analysis is used.…”

Section: Discussionmentioning

confidence: 99%

“…It is also challenging in the setting of long diffuse disease, as no healthy reference segment is available, or in ostial lesions in which technical issues such as catheter-induced spasm and non-coaxial or non-selective injections can occur. 1 , 3 , 4 , 7 , 8 In addition, conventional angiography tends to underestimate lumen dimensions and the boundaries of the plaque, which can directly cause a mismatch in sizing and lesion coverage and, therefore, stent failure and impaired clinical outcomes. 9 …”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, the use of these techniques has been associated with improved clinical outcomes, essentially in the setting of complex lesions such as bifurcations or left main disease. 1–4 …”

Section: Introductionmentioning

confidence: 99%

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What eyes do not see the heart does not grieve over? The role of intracoronary imaging in acute myocardial infarction: a case report

Blasco-Turrión,

Gómez-López,

Morales-Ponce

et al. 2023

European Heart Journal - Case Reports

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Background The evaluation of a three-dimensional structure with a two-dimensional imaging technique makes intracoronary diagnostic techniques essential, moreover in the setting of acute myocardial infarction when no apparent coronary lesions are detected. Expert consensus recommend their use in certain scenarios such as angiographically ambiguous lesions and identification of the culprit lesion and, even though both intravascular ultrasound (IVUS) and optical coherence tomography (OCT) allow the characterization of the atherosclerotic plaque and assess the immediate and long-term results of stent implantation, each of them has its own benefits and limitations which make them ideal for different types of coronary lesions. Case summary We present the case of a lateral STEMI with no evident coronary lesions in angiography, in which OCT allowed us not only to confirm a diagonal branch occlusion but it was also crucial to locate the occlusion point and to guide the procedure, allowing to complete revascularization of culprit lesion that otherwise could be missed. Discussion Knowing the actual limitations of conventional coronary angiography to adequately assess coronary disease, intracoronary diagnostic techniques are key to evaluate the underlying mechanisms of the event, moreover in the setting of acute myocardial infarction when no clear culprit lesion has been identified. They can be of great value to locate and revascularize acute occlusions that could go unnoticed on the angiogram, guiding the revascularization and stent implantation and, therefore, preventing myocardial injury that could become irreversible when coronary disease is not treated promptly.

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Section: Discussionmentioning

confidence: 99%