Dall'Orto Clarissa Campo, Ferreira Lopes Rubens Pierry, Eurípedes Lara Vilela, Pinto Filho Gilvan Vilella, da Silva Marcos Raphael
Department of Hemodynamic and Interventional Cardiology of the Advanced Hemodynamic Therapy Center, Brazilian Society of Health Support Hospital, Teixeira de Freitas 45987-088, Bahia, Brazil.
Diagnostics (Basel). 2023 Oct 3;13(19):3118. doi: 10.3390/diagnostics13193118.
Optical coherence tomography (OCT) has a high spatial resolution and is useful in identifying coronary lesions with high-risk features (vulnerable plaques). These plaques are strongly associated with acute coronary syndrome (ACS). In this report, we present the case of a 43-year-old male patient presenting with typical chest pain that began three hours prior to admission. The patient exhibited an elevation of the ST segments of the anterior and lateral walls. Invasive stratification revealed a 40% lesion in the middle segment of the left anterior descending (LAD) artery. The patient was given optimized clinical treatment as he had a nonobstructive lesion in the LAD at the time of angiography. During the treatment, the patient continued to complain of angina on exertion. A follow-up coronary angiography, along with OCT analysis of the middle-to-moderate lesion in the LAD, revealed a plaque predominantly rich in lipids with signs of vulnerability. A percutaneous coronary intervention was performed. The patient's recovery was uneventful, and he was discharged the day after the procedure. This case illustrates the evolution of intravascular imaging, particularly OCT, in the detection of vulnerable plaques.
光学相干断层扫描（OCT）具有高空间分辨率，有助于识别具有高危特征的冠状动脉病变（易损斑块）。这些斑块与急性冠状动脉综合征（ACS）密切相关。在本报告中，我们介绍了一名43岁男性患者的病例，该患者在入院前三小时开始出现典型胸痛。患者前壁和侧壁ST段抬高。侵入性分层显示左前降支（LAD）动脉中段有40%的病变。由于血管造影时患者LAD有非阻塞性病变，因此给予了优化的临床治疗。治疗期间，患者仍持续抱怨运动时心绞痛。后续冠状动脉造影以及对LAD中重度病变的OCT分析显示，有一个主要富含脂质且有易损迹象的斑块。进行了经皮冠状动脉介入治疗。患者恢复顺利，术后第二天出院。该病例说明了血管内成像，尤其是OCT在检测易损斑块方面的发展。
