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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| Format: | Article |
| Language: | English |
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Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade
2018-01-01
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| 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. |
| format | Article |
| id | doaj-art-2bd442edccbb4051b482d5d7b1e33137 |
| institution | OA Journals |
| issn | 0042-8450 2406-0720 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade |
| record_format | Article |
| 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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