JACC. Cardiovascular imaging
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JACC Cardiovasc Imaging · Mar 2013
Editorial CommentCoronary plaque erosion: recognition and management.
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JACC Cardiovasc Imaging · Mar 2013
OCT-based diagnosis and management of STEMI associated with intact fibrous cap.
In autopsy studies, at least 25% of thrombotic coronary occlusions are caused by plaque erosion in which thrombus often overlies atherosclerotic plaque without evident disruption of the fibrous cap. We performed optical coherence tomography imaging after aspiration thrombectomy and identified plaque erosion as the cause in 31 patients presenting with ST-segment elevation myocardial infarction. ⋯ At a median follow-up of 753 days, all patients were asymptomatic, regardless of stent implantation. These observations support an alternative treatment strategy for patients with acute coronary events and optical coherence tomography-verified intact fibrous cap (or plaque erosion), where nonobstructive lesions might be managed without stenting.