Intravascular Images of Coronary Stenosis with Multiple Channels in a Patient with Antiphospholipid Syndrome: The Optical Coherence Tomography Findings

• Published in: Internal Medicine Vol. 56; no. 11; pp. 1351 - 1356
• Main Authors: Ito, Shigenori, Hasuo, Takahiro
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Society of Internal Medicine 01.01.2017; Japan Science and Technology Agency
• Subjects: acute coronary syndrome; Acute Coronary Syndrome - pathology; Angiography; Antiphospholipid syndrome; Antiphospholipid Syndrome - complications; Antiphospholipid Syndrome - pathology; Autoimmune diseases; Case Report; Coronary Angiography - methods; Coronary Stenosis - complications; Coronary Stenosis - diagnostic imaging; Coronary Stenosis - pathology; Coronary Vessels - pathology; Female; Humans; Hyperplasia; Internal medicine; Lupus Erythematosus, Systemic - complications; Lupus Erythematosus, Systemic - pathology; Medical imaging; Middle Aged; Optical Coherence Tomography; recanalized thrombus; Septum; Stenosis; Stents; systemic lupus erythematosis; Systemic lupus erythematosus; Tomography; Tomography, Optical Coherence; Tunica Intima; Ultrasonography, Interventional; Ultrasound; antiphospholipid syndrome; acute coronary syndrome; optical coherence tomography; recanalized thrombus; systemic lupus erythematosis
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.56.7804

Intravascular images of coronary stenosis by antiphospholipid syndrome (APS) would be beneficial to understand the mechanism of this disease. A 59-year-old woman with APS/systemic lupus erythematosis (SLE) underwent emergent coronary angiography which revealed stenosis with micro channels in the proximal left anterior descending artery. According to optical coherence tomography (OCT), the central lumen was surrounded by a thick septum with a homogenous and high intensity. Multiple small channels existed near the vessel wall with diffuse intimal hyperplasia. White thrombi were floating distal to the stenosis. Intravascular images obtained by optical coherence tomography (OCT) revealed the microstructure of complex coronary stenosis, which had ambiguous findings on angiography and intravascular ultrasound (IVUS) in an acute coronary syndrome (ACS) patient with APS/SLE.