Honeycomb-like structure in spontaneous recanalized coronary thrombus demonstrated by serial angiograms: a case report

European Heart Journal. Case Reports
Mitsuru KahataYasuhiro Ishii

Abstract

The honeycomb-like structure (HLS) is a rare cause of myocardial ischaemia characterized by multiple communicating channels divided by thin septa. The aetiology of this specific structure remains speculative. A 55-year-old man was admitted due to worsening effort angina during the previous 2 months. Diagnostic coronary angiography revealed occlusion of the distal right coronary artery (RCA) with good collateral flow from the left coronary artery. We considered this lesion as a recent total occlusion, and planned a percutaneous coronary intervention (PCI). At the time of PCI, 7 days after admission, an angiogram showed a spontaneous recanalization of the occlusive RCA. Intravascular ultrasound (IVUS) depicted a HLS at the recanalized lesion, including atherosclerotic stenosis. We managed these lesions with drug-eluting stents. A recanalized thrombus may manifest as a HLS. In this case, the patient suffered from worsening effort angina during the previous 2 months, we confirmed a spontaneous recanalization of the occluded coronary lesion by serial angiographic images, and observed HLS adjacent to the atherosclerotic attenuated plaque by using high-resolution IVUS. Recanalized organizing thrombus is considered an entity of HLS. Ho...Continue Reading

References

Mar 19, 2011·Journal of the American College of Cardiology·Johanne SilvainJohn W Weisel
Jul 14, 2012·JACC. Cardiovascular Imaging·Soo-Jin KangSeung-Jung Park
Feb 22, 2014·JACC. Cardiovascular Interventions·Mio MusashiTaiichiro Meguro
Dec 5, 2017·Circulation Journal : Official Journal of the Japanese Circulation Society·Géraud SouteyrandPascal Motreff

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