First-in-man clinical use of combined near-infrared spectroscopy and intravascular ultrasound: a potential key to predict distal embolization and no-reflow?

摘要

A 57-year-old male with a previous myocardial infarction and primary stenting of the right coronary artery was admitted for treatment of a type A lesion in the proximal left anterior descending coronary artery (E). Fractional flow reserve was 0.68, and complex partly calcic plaque morphology was seen on multislice computed tomography (D). A novel intravascular ultrasound (IVUS) and near-infrared spectroscopic combination catheter demonstrated lipid-rich plaque extending almost 270° of the vessel circumference (A to C). Direct stenting (everolimus-eluting, 3.5 X 18 mm) obtained an excellent angiographic result (E). After the procedure, the patient experienced mild transient chest discomfort without elec-trocardiographic changes, but cardiac enzymes were elevated (troponin T 0.89 ng/ml, creatine kinase 239 U/l, myocardial band fraction 10%).