title: Spontaneous spiral dissection of left internal thoracic artery graft.
abstract: The left internal thoracic artery (LITA) is considered the most reliable coronary artery bypass grafting conduit due to its high rate of long-term patency. LITA grafts are extremely durable and associated complications are infrequent. We present a case with spontaneous spiral dissection of a LITA graft to the left anterior descending artery, which was assessed by optical coherence tomography (OCT) and intravascular ultrasound (IVUS). OCT was superior in visualizing the disrupted flap, false lumen, and intramural hematoma, but it did not visualize the full extent of the vessel wall. In contrast, IVUS allowed more complete and deeper vessel visualization, and thus better appreciation of the extent of intramural hematoma. Combined use of these two modalities provides complementary details on imaging of a LITA dissection.
authors.affiliation: Department of Cardiovascular Medicine, Nagasaki University Graduate School of Biomedical Sciences.
authors.forename: Seiji
authors.initials: S
authors.lastname: Koga
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ikeda
authors.forename: Tomoo
authors.initials: T
authors.lastname: Nakata
authors.forename: Koji
authors.initials: K
authors.lastname: Maemura
mesh_terms: D000368:Aged; D001026:Coronary Artery Bypass / Q000379:methods*; D006801:Humans; D008297:Male; D008323:Mammary Arteries / Q000000981:diagnostic imaging / Q000473:pathology* / Q000637:transplantation*; D011859:Radiography; D041623:Tomography, Optical Coherence; D018084:Ultrasonography, Interventional