OCT guided interventional OCT guided interventional therapy for borderline therapy for borderline

lesion: comparison of OCT, lesion: comparison of OCT, IVUS and CAGIVUS and CAG

Jin Qin-hua, Chen Yun-daiJin Qin-hua, Chen Yun-dai

Cardiovascular Medical CenterCardiovascular Medical CenterChinese PLA General Hospital, BeijiChinese PLA General Hospital, Beiji

ng, Chinang, China

CASE REPORT

male, 52y;male, 52y; chest pain with sweating, usually occuchest pain with sweating, usually occu

rred in the early morning;rred in the early morning; Diagnosis: UA II B;Diagnosis: UA II B; Risk factor: Hypertention; Smoking (1 Risk factor: Hypertention; Smoking (1

pack/day)pack/day) UCG: EF 58%, hypokinesis inferior waUCG: EF 58%, hypokinesis inferior wa

llll

CAG 2010-4-CAG 2010-4-1616

-- Mid LAD 43.44% stenosis;-- Mid LAD 43.44% stenosis; -- Mid RCA 44.47% stenosis;-- Mid RCA 44.47% stenosis;

Diameter stenosis: 43.44%

Diameter stenosis: 44.47%

IVUS-LADIVUS-LAD

• Vascular stenosis=MLA/vascular reference area: 66%

RCA-IVUSRCA-IVUS

There exists some irregular soft mass of the surface of plaque. Thrombus?

• Vascular stenosis=MLA/vascular reference area: 38.8%

StrategyStrategy

intensified anti-thrombosis therapy?intensified anti-thrombosis therapy? interventional therapy?interventional therapy? further assessment of the RCA lesion?further assessment of the RCA lesion?

RCA-OCTRCA-OCT

1

6

5

4

3

2Lipid plaque, multi-point plaque ruptures, and thrombosis; MLA 3.74mm2;

RCA-stentingRCA-stenting

Discussion Discussion

It’s required to adequate lesion evaluIt’s required to adequate lesion evaluation using different imaging modalitieation using different imaging modalities in the some selected patients.s in the some selected patients.

-- the symptom couldn’t be explained by -- the symptom couldn’t be explained by the CAG.the CAG.

-- when the image is indefinite-- when the image is indefinite OCT is very helpful in detecting the vulOCT is very helpful in detecting the vul

nerable plaque. nerable plaque.