Revista Española de Cardiología (English Edition) Revista Española de Cardiología (English Edition)
Rev Esp Cardiol. 2005;58:301 - Vol. 58 Num.03 DOI: 10.1016/S1885-5857(06)60492-1

Complex Coronary Lesion Demonstrated With Multidetector CT

Gabriel C Fernández a, Manuel Vilar b, Ramón Mantilla c

a Servicio de Radiodiagnóstico, Centro Médico POVISA, Vigo, Pontevedra, Spain.
b Servicio de Cardiología, Centro Médico POVISA, Vigo, Pontevedra, Spain.
c Servicio de Cardiología y Hemodinámica, Hospital Meixoeiro, Vigo, Pontevedra, Spain.

Article

A 45-year-old male, smoker, and with no other cardiovascular risk factors was hospitalized for an inferior myocardial infarction. Fibrinolysis treatment was administered causing the clinical and electrocardiograph signs to disappear. A contrast-enhanced CT examination using a 16-multidetector CT was performed 3 days later. An atherosclerotic plaque with density measurements less than 50 HU (Hounsfield units) was observed in the proximal right coronary artery (RCA) (Figure 1A). Also, a small perfusion defect was observed in the inferior wall of the LV (Figure 1B). This plaque was classified as a complex lesion with 60% stenosis of the vessel lumen in a 60%. Several days later the patient presented with exertional angina and a SPECT was performed demonstrating a perfusion defect in the inferior myocardial wall with signs of viability. A coronary stent was implanted in the RCA. Two months later, when the patient presented with a typical chest pain a multidetector CT examination. The CT showed the coronary stent in a correct location (Figure 2A, 2B) with permeability within the lumen (Figure 3a, 3B). Thus, a conventional coronary angiogram was avoided.

Fig. 1.

Fig. 2.

Fig. 3.

Vulnerable plaques with a lipid -rich core can be demonstrated with this non-invasive imaging method, particularly when they have a density values less than 50 HU. In addition , in this case as in many others, multidetector CT can be used to evaluate the location and permeability of a coronary stent.

1885-5857/© 2005 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved

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