title: A patient with significant slow-flow phenomenon during percutaneous coronary intervention for ST elevation myocardial infarction associated with scattered necrotic core by virtual histology intravascular ultrasound.
abstract: A 68-year-old man with acute ST elevation myocardial infarction (STEMI) underwent emergent coronary angiography which showed total occlusion in the proximal right coronary artery (RCA). Gray-scale intravascular ultrasound (IVUS) revealed the culprit lesion was expansively remodeled and contained ruptured and echolucent plaques with spotty calcification, whereas thin-capped fibroatheroma and a large amount of scattered necrotic core were observed by virtual histology (VH)-IVUS. After stent implantation in the proximal RCA under a filter protection, filter-no-reflow phenomenon occurred and thrombus-like defect was observed in the mid RCA. Under these conditions, VH-IVUS detected a large amount of scattered necrotic core in the mid RCA. We suggest scattered necrotic core detected by VH-IVUS may be associated with slow-flow phenomenon during percutaneous coronary intervention in our patient with STEMI.
authors.affiliation: Department of Cardiology, Takaoka Municipal Hospital, 4-1 Takara-machi, Takaoka, 933-8550, Japan, tatsuo_haraki@municipal-hp-takaoka.jp.
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Haraki
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Hirase
authors.forename: Munenori
authors.initials: M
authors.lastname: Ohta
authors.forename: Yoshihide
authors.initials: Y
authors.lastname: Uno
authors.forename: Kenji
authors.initials: K
authors.lastname: Sakata
authors.forename: Masa-Aki
authors.initials: MA
authors.lastname: Kawashiri
authors.forename: Masakazu
authors.initials: M
authors.lastname: Yamagishi