When Coronary Angiography Does Not Give You the Answer, Look More in Detail

Alessandra Laricchia, Mario Gramegna, Satoru Mitomo, Daisuke Hachinohe, Massimo Slavich, Anna Palmisano, Antonio Esposito, Antonio Colombo and Francesco Giannini

Department of Interventional Cardiology Unit, Maria Cecilia Hospital, Italy
Department of Cardiology, IRCCS San Raffaele Scientific Institute, Italy
Department of Radiology, IRCCS San Raffaele Scientific Institute, Italy

^*Correspondance to: Francesco Giannini 

 PDF  Full Text DOI: 10.25107/2474-1647.2458

Abstract

Integrating multiple imaging modalities: A 50-year-old male presenting with refractory cardiac arrest was treated by Extracorporeal Membrane Oxygenation (ECMO) and underwent Coronary Angiography (CAG) that excluded significant coronary disease. However, supported by a Cardiac Magnetic Resonance (CMR) showing findings compatible with an acute ischemic event on the anterior wall, CAG was repeated together with Optical Coherence Tomography (OCT) imaging: it showed a critical lesion with mural thrombus in the mid Left Anterior Descending (LAD) that was successfully treated with implantation of a drug-eluting stent. Intracoronary imaging is a very important tool to analyze plaque morphology when CAG alone is not sufficient. Moreover this case demonstrates the possible value of intravascular imaging to aid in decision making in patients presenting following cardiac arrest.

Keywords

Cite the article

Laricchia A, Gramegna M, Mitomo S, Hachinohe D, Slavich M, Palmisano A, et al. When Coronary Angiography Does Not Give You the Answer, Look More in Detail. Clin Surg. 2019; 4: 2458.