Medicina Intensiva  (English Edition) Medicina Intensiva  (English Edition)
Med Intensiva 2017;41:508 - Vol. 41 Num.8 DOI: 10.1016/j.medine.2016.02.007
Images in Intensive Medicine
Intracoronary thrombus in a patient with recurrent vasospasm: Findings of optical coherence tomography
Trombo intracoronario en paciente con vasoespasmo recurrente: hallazgos de la tomografía de coherencia óptica
T. Bastantea, A. García-Cabellob, F. Alfonsoa,,
a Servicio de Cardiología, Hospital Universitario de La Princesa, Madrid, Spain
b Servicio de Cardiología, Hospital Universitario del Henares, Coslada, Madrid, Spain

A 45-year-old male with non-ST segment elevation coronary syndrome. Coronariography showed mild stenosis with smooth margins in the proximal anterior descending artery (Fig. 1A, arrow). Vasospasm testing proved clinically, electrically and angiographically positive (Fig. 1B: absence of flow–arrows). Optical coherence tomography (OCT) in turn revealed an underlying atheroma plaque of fibrolipidic characteristics, with no evidence of rupture (Fig. 1C). A curious thin laminar thrombus of platelet characteristics was identified, lining the endothelium (arrows). Vasospasm proved recurrent, leading to invasive re-evaluation; the OCT study one month later showed the laminar thrombus in the spastic zone to have become incorporated into the wall, forming a continuum with the arterial intimal layer (Fig. 1D; * guide artifact).

Figure 1.
(0.29MB).

Please cite this article as: Bastante T, García-Cabello A, Alfonso F. Trombo intracoronario en paciente con vasoespasmo recurrente: hallazgos de la tomografía de coherencia óptica. Med Intensiva. 2017;41:508.

Corresponding author. (F. Alfonso falf@hotmail.com)
Copyright © 2016. Elsevier España, S.L.U. and SEMICYUC
Med Intensiva 2017;41:508 - Vol. 41 Num.8 DOI: 10.1016/j.medine.2016.02.007
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