Serial examinations of right coronary artery directly injured by radiofrequency catheter ablation with optical coherence tomography and intravascular ultrasound
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A 42-year-old man was referred for ablation. The origin of VT was localized close to the right coronary ostium. During ablation, the catheter tip inadvertently fell into a RCA ostium. The patient developed chest discomfort and ST-segment elevation in the inferior leads was observed. Coronary angiography confirmed severe narrowing of the ostial RCA. Stenting was deferred after satisfactory dilatation by a balloon. The patient discharged with eventless clinical course afterward. Follow-up coronary angiographic, FD-OCT, IVUS, and iMap examinations were performed at 3, 6, and 15 months after index procedure. The lesion showed progressive positive remodeling associated with intimal proliferation, medial thickening, and lumen narrowing up to 6 months. The patient underwent stenting at 15 months after the index procedure. The lesion required high-pressure post dilatation to obtain optimal stent expansion.
KeywordsCatheter ablation Complication Coronary artery injury PCI FD-OCT IVUS
Compliance with ethical standards
Conflict of interest
All study participants provided informed consent, and the study design was approved by the appropriate ethics review boards. There are no conflicts of interest to declare.
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