Key result
Intravascular ultrasound successfully guided the percutaneous coronary intervention strategy by identifying a large plaque burden and residual thrombus without significant stenosis, allowing for deferred stenting.
Why the study?
Defining the best PCI strategy in acute myocardial infarction is difficult given the need for rapid reperfusion, prompting the use of invasive imaging modalities like IVUS.
Case Report (n=1)
No
Intravascular imaging modalities such as IVUS and OCT can identify plaque characteristics and predictors of no-reflow to guide PCI strategy in acute myocardial infarction.
May support intravascular imaging for no-reflow risk stratification in AMI PCI; hypothesis-generating and requires prospective trials before practice change.
Defining the best percutaneous coronary intervention (PCI) in acute myocardial infarction is sometimes difficult, bearing in mind that time is of the essence in preventing myocardial tissue damage. There are invasive modalities to determine the best strategy. These include intravascular ultrasound (IVUS) and optical coherence tomography (OCT), methods that could underline plaque rupture, thrombus, positive remodeling, greater plaque burden, and tissue prolapse. Virtual histology IVUS is capable of detecting lesions containing large necrotic cores and thin cap fibroatheroma (independent predictors of no-reflow in acute myocardial patients). Using these imagistic modalities can lead the PCI strategy in order to obtain the best possible outcome of the procedure for the patient.
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Cîrjan et al. (2022) conducted a case report in Acute myocardial infarction (STEMI) (n=1). Intravascular ultrasound and aspiration thrombectomy was evaluated. Intravascular ultrasound successfully guided the percutaneous coronary intervention strategy by identifying a large plaque burden and residual thrombus without significant stenosis, allowing for deferred stenting.
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