Extremely tortuous coronary arteries - when optical coherence tomography and fractional flow reserve did not help us much

Introduction. Extreme coronary tortuosity may lead to flow alteration resulting in a reduction in coronary pressure distal to the tortuous segment, subsequently leading to ischemia. Therefore the detection of a true cause of ischemia, i.e. whether a fixed stenosis or tortuosity by itself is responsi...

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Main Authors: Miloradović Vladimir, Nikolić Dušan, Srećković Miodrag, Đokić-Nikolić Ivana
Format: Article
Language:English
Published: Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade 2018-01-01
Series:Vojnosanitetski Pregled
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Online Access:http://www.doiserbia.nb.rs/img/doi/0042-8450/2018/0042-84501600213M.pdf
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author Miloradović Vladimir
Nikolić Dušan
Srećković Miodrag
Đokić-Nikolić Ivana
author_facet Miloradović Vladimir
Nikolić Dušan
Srećković Miodrag
Đokić-Nikolić Ivana
author_sort Miloradović Vladimir
collection DOAJ
description Introduction. Extreme coronary tortuosity may lead to flow alteration resulting in a reduction in coronary pressure distal to the tortuous segment, subsequently leading to ischemia. Therefore the detection of a true cause of ischemia, i.e. whether a fixed stenosis or tortuosity by itself is responsible for its creation, with non-invasive and invasive methods is a real challenge. Case report. We presented a case of a patient with a history of stable angina [Canadian Cardiovascular Society (CCS class II)], an abnormal stress test and coronary tortuosity without hemodynamically significant stenosis. Due to suspected linear lesion between the two bends in proximal segment of Right coronary artery (RCA) we performed optical coherence tomography (OCT), minimum lumen area (MLA)-13.19 mm2) and fractional flow reserve (FFR) RCA (0.94). We opted for conservative treatment for stable angina. Conclusion. When tortuosities are associated with atherosclerosis in coronary artery for determination of true cause of ischemia invasive methods can be used, such as OCT and FFR.
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publishDate 2018-01-01
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series Vojnosanitetski Pregled
spelling doaj-art-2bd442edccbb4051b482d5d7b1e331372025-08-20T02:01:51ZengMinistry of Defence of the Republic of Serbia, University of Defence, BelgradeVojnosanitetski Pregled0042-84502406-07202018-01-0175110010310.2298/VSP160316213M0042-84501600213MExtremely tortuous coronary arteries - when optical coherence tomography and fractional flow reserve did not help us muchMiloradović Vladimir0Nikolić Dušan1Srećković Miodrag2Đokić-Nikolić Ivana3Clinical Center of Kragujevac, Cardiology Clinic, Department of Interventional Cardiology, KragujevacClinical Center of Kragujevac, Cardiology Clinic, Department of Interventional Cardiology, KragujevacClinical Center of Kragujevac, Cardiology Clinic, Department of Interventional Cardiology, KragujevacClinical Center of Kragujevac, Cardiology Clinic, Department of Interventional Cardiology, KragujevacIntroduction. Extreme coronary tortuosity may lead to flow alteration resulting in a reduction in coronary pressure distal to the tortuous segment, subsequently leading to ischemia. Therefore the detection of a true cause of ischemia, i.e. whether a fixed stenosis or tortuosity by itself is responsible for its creation, with non-invasive and invasive methods is a real challenge. Case report. We presented a case of a patient with a history of stable angina [Canadian Cardiovascular Society (CCS class II)], an abnormal stress test and coronary tortuosity without hemodynamically significant stenosis. Due to suspected linear lesion between the two bends in proximal segment of Right coronary artery (RCA) we performed optical coherence tomography (OCT), minimum lumen area (MLA)-13.19 mm2) and fractional flow reserve (FFR) RCA (0.94). We opted for conservative treatment for stable angina. Conclusion. When tortuosities are associated with atherosclerosis in coronary artery for determination of true cause of ischemia invasive methods can be used, such as OCT and FFR.http://www.doiserbia.nb.rs/img/doi/0042-8450/2018/0042-84501600213M.pdfcoronary vesselsangina pectorisblood flow velocitycoronary angiographytomography, optical coherence
spellingShingle Miloradović Vladimir
Nikolić Dušan
Srećković Miodrag
Đokić-Nikolić Ivana
Extremely tortuous coronary arteries - when optical coherence tomography and fractional flow reserve did not help us much
Vojnosanitetski Pregled
coronary vessels
angina pectoris
blood flow velocity
coronary angiography
tomography, optical coherence
title Extremely tortuous coronary arteries - when optical coherence tomography and fractional flow reserve did not help us much
title_full Extremely tortuous coronary arteries - when optical coherence tomography and fractional flow reserve did not help us much
title_fullStr Extremely tortuous coronary arteries - when optical coherence tomography and fractional flow reserve did not help us much
title_full_unstemmed Extremely tortuous coronary arteries - when optical coherence tomography and fractional flow reserve did not help us much
title_short Extremely tortuous coronary arteries - when optical coherence tomography and fractional flow reserve did not help us much
title_sort extremely tortuous coronary arteries when optical coherence tomography and fractional flow reserve did not help us much
topic coronary vessels
angina pectoris
blood flow velocity
coronary angiography
tomography, optical coherence
url http://www.doiserbia.nb.rs/img/doi/0042-8450/2018/0042-84501600213M.pdf
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