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Rotational Atherectomy

Abstract

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Clinical Case Study2018 Jan 1;19(1):116.

JOURNAL:Eur Heart J Cardiovasc Imaging. Article Link

In vivo comparison of lipid-rich plaque on near-infrared spectroscopy with histopathological analysis of coronary atherectomy specimens

Nishihira K, Asaumi Y, Kataoka Y et al. Keywords: atherectomy, coronary spectroscopy, near-infrared lipids

ABSTRACT


A 42-year-old man with angina pectoris was hospitalized to undergo percutaneous coronary intervention (PCI) for a significant stenosis in the mid-left anterior descending (LAD) coronary artery (Panel A). Optical coherence tomography (OCT) and near-infrared spectroscopy (NIRS) imaging at the arrowhead site identified the presence of lipid-rich plaque, exhibiting a high maximum 4-mm lipid core burden index (max-LCBI) with the value of 925 (Panels B and C; Supplementary data online, Video S1). Following PCI with directional coronary atherectomy (DCA), resection of the lipid-rich plaque was observed on OCT imaging (Panels D and D’; Supplementary data online, Video S2). Corresponding NIRS imaging demonstrated a marked reduction of yellow signals on chemogram accompanied by decrease in max-LCBI to 248 (Panel E,asterisk).