Optical frequency domain imaging-guided rotational atherectomy followed by drug-coated balloon dilation to the non-calcified lesion in a patient with severe thrombocytopenia
Images in Cardiovascular Intervention
A 77-year-old man with aplastic anemia was admitted to our hospital due to worsening heart failure. Approximately 1 year earlier, he underwent left main (LM)-left anterior descending coronary artery (LAD) crossover stenting with a bare metal stent (BMS) [ 1]. A routine blood test at admission showed pancytopenia (platelet 2000/μL, hemoglobin 6.3 g/dL, white blood cell 3120/μL) and coronary angiography (CAG) indicated a subtotal occlusion in the mid-distal right coronary artery (RCA) without in-stent restenosis of the BMS in LM-LAD (Supplementary Fig. 1). Because of refractory heart failure and severe thrombocytopenia, we performed transradial stentless percutaneous coronary intervention (PCI) against the RCA lesion after transfusions, using rotational atherectomy (RA) and drug-coated balloon (DCB) under aspirin and intravenous heparin (Fig. 1a). Pre-procedural optical frequency domain imaging (OFDI) showed diffuse fibrous plaque as well as micro channels and deep layered area with...
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Conflict of interest
The authors have no conflicts of interest regarding the content of the manuscript.
© Japanese Association of Cardiovascular Intervention and Therapeutics 2017