Thrombus aspiration without stenting in a patient with anterior STEMI: Regression and healing of an unstable plaque assessed by OCT at 24 months of follow‐up

Figures

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  FIGURE 1. Initial arteriography revealed single vessel disease and a thrombus containing lesion at the LAD ostium (arrow)

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  FIGURE 2. Angiography and OCT immediately after Interventional procedure: (A) arteriography after thrombus aspiration shows vessel lumen with minimal residual stenosis (“stent‐like” result) and no signs of a thrombotic mass (arrow). (B) OCT examination after thrombus aspiration demonstrated unstable plaque with a large necrotic core (NC) and ruptured fibrotic cap (arrow). No concomitant thrombus seen along a ruptured plaque. (C) 3D reconstruction of the ruptured plaque area allows to see location of a rupture in LAD lumen (arrow) and its relation to the CxA ostium

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  FIGURE 3. Control angiography and OCT examination after 3 months of the initial PCI procedure: (A) no restenosis was detected in LAD by angiography at the site of previous thrombus aspiration without stenting (arrow); (B) OCT examination shown complete endothelization of a previously ruptured plaque surface (arrows), but residual necrotic core of the plaque still persisted (marked by an asterisk)

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  FIGURE 4. 14‐month follow‐up result assessed by angiography and OCT: (A) control angiography shows LAD without restenosis after initial intervention (arrow). (B) OCT picture revealed small fibrotic plaque (asterisk) at the site of previously unstable and ruptured plaque

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  FIGURE 5. Control arteriography and OCT of the LAD 24 months later: (A) LAD without restenosis after primary coronary intervention (arrow). (B) Small stable plaque (asterisk) detected by OCT without significant changes in plaque size and tissue composition compared to 14‐month follow‐up result. Classic 3‐layered structure of the vessel wall is clearly visible (media signed by arrows)