Key result
Optical coherence tomography confirmed complete healing of an untreated type C coronary dissection and revealed a complicated plaque with associated thrombus as the substrate for proximal restenosis.
Case Report (n=1)
OCT provides valuable insights into the complete spontaneous healing of untreated coronary dissections and the mechanisms underlying restenosis.
OCT insights into spontaneous dissection healing and restenosis mechanisms remain hypothesis-generating; should not yet change practice.
A 68-year-old patient presented a long, type C coronary dissection after balloon angioplasty of a focal lesion in a distal marginal branch. Due to the small vessel size the dissection was left untreated. At angiographic follow-up the dissection had completely disappeared, but a localised restenosis was found in the proximal vessel. Optical coherence tomography (OCT) confirmed the complete healing of the dissection and revealed a normal vessel wall (restitutio ad integrum). This technique also provided unique insights into the underlying substrate of the proximal restenosis unravelling a complicated plaque with associated thrombus.
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Alfonso et al. (2011) conducted a case report in Coronary dissection (n=1). Conservative management (untreated dissection) and Optical Coherence Tomography (OCT) was evaluated on Healing of dissection and restenosis. Optical coherence tomography confirmed complete healing of an untreated type C coronary dissection and revealed a complicated plaque with associated thrombus as the substrate for proximal restenosis.
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