Key result
In a 68-year-old male with acute coronary syndrome, CCTA combined with pericoronary inflammation mapping successfully guided the use of a cutting balloon and stenting for heavily calcified lesions, resulting in an event-free 1-month follow-up.
Case Report (n=1)
CCTA combined with pericoronary inflammation mapping (FAI) can aid in preprocedural planning for complex PCI in patients with multivessel disease and heavily calcified lesions.
CCTA inflammation mapping may aid plaque phenotyping in complex atherosclerosis; leaves open clinical utility pending prospective validation.
Complex coronary atherosclerosis may exhibit different phenotypes of coronary plaques, from non-calcified highly vulnerable atheroma to heavily calcified ones. Computed coronary tomography angiography (CCTA) may identify these different phenotypes and the recently introduced CCTA-based techniques for mapping coronary inflammation along the coronary arteries may provide useful additional information on cardiovascular risk. Here we present the case of a 68-year-old male patient with acute coronary syndrome in whom invasive coronary angiography and CCTA revealed a severe three-vessel disease with a heavily calcified lesion. Mapping of the CT fat attenuation index along the coronary arteries identified a high level of coronary inflammation, especially associated with the non-calcified lesions. All lesions were successfully revascularized by implantation of drug-eluting stents. A cutting balloon was used for the lesion identified by CCTA as heavily calcified, followed by stent implantation, with good results. In conclusion, CCTA, in association with novel techniques for mapping coronary inflammation, may represent an extremely useful tool for preparing complex interventions in multivessel diseases, helping preprocedural planning in high-risk patients.
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Blîndu et al. (2023) conducted a case report in Acute Coronary Syndrome (n=1). Cutting balloon and drug-eluting stent implantation guided by CCTA and FAI mapping was evaluated on Successful revascularization and clinical outcome. In a 68-year-old male with acute coronary syndrome, CCTA combined with pericoronary inflammation mapping successfully guided the use of a cutting balloon and stenting for heavily calcified lesions, resulting in an event-free 1-month follow-up.
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