PMC8086666_01
Coronary angiography (CAG) and optical frequency domain imaging (OFDI) findings of the culprit lesion at the time of percutaneous coronary intervention (PCI) and subsequent follow-up CAG. A. CAG before PCI showing severe stenosis at the ostium of the left circumflex artery (white arrow); B. OFDI image before PCI showing eccentric severe calcification (asterisks), and a minimum lumen area (MLA) of 1.4 mm2; C. OFDI image after excimer laser coronary angioplasty with MLA of 2.6 mm2; D. Final OFDI image at the PCI demonstrates a small plaque dissection (white arrows) and MLA of 3.9 mm2; E. CAG after PCI showing optimal results; F. CAG at follow-up shows no restenosis; G. OFDI at follow-up CAG showing improvements in plaque dissection and a slight reduction in the MLA from 3.9 mm2 to 3.6 mm2.
cardj-26-3-294f1.jpg
PMC8086666_01_cardj-26-3-294f1.jpg
f1-cardj-26-3-294
Coronary angiography (CAG) revealed 90% stenosis at the ostium of the left circumflex artery (LCX) (Fig. 1A). Excimer laser coronary angioplasty (ELCA) was performed using a 0.9 mm concentric laser catheter at a pulse rate of 25 Hz and energy output of 45 mJ/mm2, 35 Hz and 55 mJ/mm2, and 45 Hz and 60 mJ/mm2 for a total of 5200 pulses and balloon angioplasty using a drug-coated balloon (DCB) under the guidance of optical frequency domain imaging (OFDI), which revealed fibrous plaque and eccentric severe calcification (Fig. 1B). After ELCA, minimum lumen area (MLA) increased from 1.4 mm2 to 2.6 mm2 (Fig. 1C) and on final OFDI to 3.9 mm2 along with minor plaque dissection (Fig. 1D). Final CAG demonstrated optimal result without flow limitation (Fig 1E). Follow-up CAG demonstrated no restenosis at the ostium of the LCX (Fig. 1F). OFDI showed that the MLA slightly decreased from 3.9 mm2 to 3.5 mm2 and that the minor dissection had clearly improved (Fig. 1G).