Department of Cardiology, First Hospital of Jilin University, Changchun, China.
BMC Cardiovasc Disord. 2024 Aug 28;24(1):454. doi: 10.1186/s12872-024-04123-3.
Woven coronary artery (WCA) is a rare and underdiagnosed congenital anomaly that involves multiple thin and tortuous epicardial arterial conduits reassembling distally into a single lumen. Recanalized thrombus may present as woven-like coronary arteries, appearing similar to WCA on angiographic images.
A 58-year-old female patient with intermittent chest pain for 5 years and polycythaemia vera (PV) for 8 years. The left anterior descending artery was presented like WCA on coronary angiography and finally confirmed as recanalized thrombus by optical coherence tomography(OCT), which might have been caused by PV. Given the patient's high thrombotic risk of PV and thrombotic changes in the left circumflex artery (LCX), we ultimately chose a conservative treatment without stenting.
OCT would be needed for the diagnosis and differential diagnosis of woven-like coronary arteries. And physicians should take an appropriate treatment in a personalized way in patients with PV.
编织状冠状动脉（WCA）是一种罕见且诊断不足的先天性异常，涉及多个薄而扭曲的心外膜动脉导管，在远端重新组合成一个单一的管腔。再通的血栓可能表现为编织状冠状动脉，在血管造影图像上与 WCA 相似。
一名 58 岁女性患者，有 5 年间歇性胸痛病史和 8 年真性红细胞增多症（PV）病史。左前降支在冠状动脉造影上表现为 WCA，最终通过光学相干断层扫描（OCT）证实为再通血栓，可能由 PV 引起。鉴于患者的 PV 血栓形成高风险和回旋支（LCX）的血栓变化，我们最终选择了不进行支架置入的保守治疗。
OCT 对于编织状冠状动脉的诊断和鉴别诊断是必要的。对于 PV 患者，医生应根据患者的具体情况进行个体化的治疗。
