Geriatric Cardiology Department of the Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing 100853, China.
Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100037, China.
J Interv Cardiol. 2020 Oct 27;2020:1031675. doi: 10.1155/2020/1031675. eCollection 2020.
Based on optical coherence tomography (OCT), we aimed to determine the diagnosis, clinical characteristics, and interventions of braid-like coronary arteries, which are rare and tend to be diagnosed as a woven coronary artery (WCA) anomaly.
We identified braid-like lesions on coronary angiography (CAG) in 7 patients (6 men; median age 47 years; age range 26 to 57 years). All patients were heavy smokers. Four patients were diagnosed with an old myocardial infarction and the other 3 with unstable angina. The braid-like lesions were located in the left anterior descending arteries in 2 patients and in the right coronary arteries in the other 5. TIMI grade 2 flow was observed in all involved vessels. OCT findings of all lesions were consistent with recanalization of organized thrombi, which consisted of septa that divided the lumen into multiple small cavities communicating with each other. No separate three-layered structure could be defined. Based on the significance of the stenosis and its related symptoms, drug-eluting stents were implanted in all of the lesions. All patients experienced symptomatic improvement after the intervention and were followed up event-free for 12 months.
Braid-like coronary arteries are likely to undergo recanalization of organized thrombi rather than WCA according to our OCT findings. The majority of cases affect men who smoke heavily. Percutaneous stent implantation may be beneficial in selected patients when feasible.
基于光学相干断层扫描（OCT），我们旨在确定辫状冠状动脉的诊断、临床特征和干预措施，因为它们很罕见，并且往往被误诊为编织状冠状动脉（WCA）异常。
我们在 7 名患者（6 名男性；中位年龄 47 岁；年龄范围 26 至 57 岁）的冠状动脉造影（CAG）上发现了辫状病变。所有患者均为重度吸烟者。4 名患者被诊断为陈旧性心肌梗死，其余 3 名患者被诊断为不稳定型心绞痛。2 名患者的辫状病变位于左前降支，其余 5 名患者位于右冠状动脉。所有受累血管均观察到 TIMI 血流分级 2 级。所有病变的 OCT 检查结果均与已形成的血栓再通一致，这些血栓由分隔管腔并使其分成多个相互连通的小腔的隔膜组成。无法定义单独的三层结构。根据狭窄的严重程度及其相关症状，所有病变均植入药物洗脱支架。所有患者在介入治疗后症状均得到改善，并且在 12 个月的随访期间无事件发生。
根据我们的 OCT 检查结果，辫状冠状动脉很可能经历已形成血栓的再通，而不是 WCA。大多数病例影响大量吸烟的男性。在可行的情况下，经皮支架植入术可能对选择的患者有益。
