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Cardiovascular Intervention and Therapeutics

, Volume 32, Issue 1, pp 62–65 | Cite as

Serial examinations of right coronary artery directly injured by radiofrequency catheter ablation with optical coherence tomography and intravascular ultrasound

  • Makoto Araki
  • Tetsumin Lee
  • Tadashi Murai
  • Tsunekazu KakutaEmail author
Case Report

Abstract

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.

Keywords

Catheter ablation Complication Coronary artery injury PCI FD-OCT IVUS 

Notes

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.

Supplementary material

Supplementary material 1 (AVI 5068 kb)

Supplementary material 2 (AVI 2167 kb)

Supplementary material 3 (AVI 4916 kb)

Supplementary material 4 (AVI 5112 kb)

Supplementary material 5 (AVI 3895 kb)

Supplementary material 6 (AVI 4044 kb)

References

  1. 1.
    Leo M, De maria GL, Betts TR, Banning AP. Management and optical coherence tomography imaging of an acute coronary artery injury induced by radiofrequency catheter ablation. Int J Cardiol. 2014;174(2):e44–6.CrossRefPubMedGoogle Scholar
  2. 2.
    Templin C, Jaquszewski M, Ghadri JR, et al. Vascular lesions induced by renal nerve ablation as assessed by optical coherence tomography: pre- and post-procedural composition with the Simplicity catheter system and the EnligHTN multi-electrode renal denervation catheter. Eur Heart J. 2013;34:2141–8.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Roberts-Thomson KC, Steven D, Seiler J. Coronary artery injury due to catheter ablation in adults: presentations and outcomes. Circulation. 2009;120(15):1465–73.CrossRefPubMedGoogle Scholar
  4. 4.
    Lustgarten DL, Bell S, Hardin N, Calame J, Spector PS. Safety and efficacy of epicardial cryoablation in a canine model. Heart Rhythm. 2005;2:82–90.CrossRefPubMedGoogle Scholar
  5. 5.
    Viles-gonzalez JF, De Castro Miranda R, Scanavacca M, Sosa E, D’avila A. Acute and chronic effects of epicardial radiofrequency applications delivered on epicardial coronary arteries. Circ Arrhythm Electrophysiol. 2011;4(4):526–31.CrossRefPubMedGoogle Scholar

Copyright information

© Japanese Association of Cardiovascular Intervention and Therapeutics 2015

Authors and Affiliations

  • Makoto Araki
    • 1
  • Tetsumin Lee
    • 1
  • Tadashi Murai
    • 1
  • Tsunekazu Kakuta
    • 1
    Email author
  1. 1.Department of Cardiovascular MedicineTsuchiura Kyodo General HospitalTsuchiuraJapan

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