Key result
Multivessel drug eluting stenting successfully treated a post-menopausal woman with diffuse coronary intramural hematoma visualized only on intravascular ultrasound.
Case Report (n=1)
This case highlights the importance of multimodality imaging, specifically intravascular ultrasound, for diagnosing and guiding treatment of angiographically invisible coronary intramural hematomas.
IVUS may identify treatable hematomas missed on angiography; leaves open whether this extends to routine practice or broader populations.
Spontaneous coronary dissections are a well described entity which are often difficult to treat. Intramural hematoma is one type of coronary dissection. Previous case reports have described the treatment for angiographically visible dissection. We describe the first report of diffuse intramural hematoma visualized only on intravascular ultrasound with no angiographically obvious evidence of dissection treated with multivessel drug eluting stenting. This case highlights the importance of a high level of suspicion and atypical presentations of coronary dissection, and the use of multimodality imaging with intravascular ultrasound and computerized tomography for both diagnosis and therapy.
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Ducas et al. (2011) conducted a case report in Circumferential Multi-Vessel Coronary Intramural Hematoma (n=1). Multivessel drug eluting stenting guided by intravascular ultrasound was evaluated. Multivessel drug eluting stenting successfully treated a post-menopausal woman with diffuse coronary intramural hematoma visualized only on intravascular ultrasound.
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