title: Intravascular imaging in Kounis syndrome: role of IVUS and OCT in achieving an etiopathogenic diagnosis.
abstract: We report a case of a 60-year-old male patient presenting with anaphylactic response to anchovies associated with an acute coronary syndrome. His history was remarkable for coronary artery disease treated with a drug eluting stent to the right coronary artery six years before and stent fracture documented by coronary angiography four years prior to the event. Coronary angiography on admission revealed a very late stent thrombosis (VLST) in the right coronary artery. Intracoronary imaging techniques (IVUS and OCT) were used and were key to discard main causes of VLST. We described the characteristics of intracoronary images, along with the advantages and disadvantages of these techniques. The findings described in this case could explain a new physiopathological mechanism of stent thrombosis occurring in stent fractures.
authors.affiliation: Department of Cardiology, Hospital Universitario Puerta de Hierro, 28222 Madrid, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Domínguez
authors.affiliation: Department of Cardiology, Hospital Universitario Puerta de Hierro, 28222 Madrid, Spain.
authors.forename: Arturo
authors.initials: A
authors.lastname: García-Touchard
authors.affiliation: Department of Cardiology, Hospital Universitario Puerta de Hierro, 28222 Madrid, Spain.
authors.forename: Susana Mingo
authors.initials: SM
authors.lastname: Santos
authors.affiliation: Department of Cardiology, Hospital Universitario Puerta de Hierro, 28222 Madrid, Spain.
authors.forename: Juan Manuel
authors.initials: JM
authors.lastname: Escudier-Villa
authors.affiliation: Department of Cardiology, Hospital Universitario Puerta de Hierro, 28222 Madrid, Spain.
authors.forename: Diego
authors.initials: D
authors.lastname: Jiménez-Sánchez
authors.affiliation: Department of Cardiology, Hospital Universitario Puerta de Hierro, 28222 Madrid, Spain.
authors.forename: Josebe Goirigolzarri
authors.initials: JG
authors.lastname: Artaza
authors.affiliation: Department of Cardiology, Hospital Universitario Puerta de Hierro, 28222 Madrid, Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: Alonso-Pulpón
authors.affiliation: Department of Cardiology, Hospital Universitario Puerta de Hierro, 28222 Madrid, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Goicolea
keywords: IVUS; Kounis syndrome; OCT; Stent thrombosis