Elongated eccentric soft coronary plaque: major diagnostic pitfall on quantitative coronary angiography overpowered by computed tomography coronary angiography and intravascular ultrasound.
We describe a significant left anterior descending coronary lesion in a patient with unstable angina pectoris. This lesion was erroneously underestimated using quantitative coronary angiography; however, CT coronary angiography correctly showed a significant, elongated, eccentric, soft plaque that was later confirmed by repeated quantitative coronary angiography with intravascular ultrasound. As showed, CT coronary angiography may offer a reliable non-invasive alternative to quantitative coronary angiography and intravascular ultrasound by enabling a true 3-D coronary lumenogram combined with plaque detection and characterization.
Ghersin
E
E
Department of Radiology, Rambam Medical Center, B. Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel. e_ghersin@rambam.health.gov.il
Litmanovich
D
D
Kerner
A
A
Engel
A
A
Hayek
T
T
D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000628:therapy; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D006801:Humans; D008297:Male; D008875:Middle Aged; D015607:Stents; D014057:Tomography, X-Ray Computed; D018084:Ultrasonography, Interventional