title: Serial examinations of right coronary artery directly injured by radiofrequency catheter ablation with optical coherence tomography and intravascular ultrasound.
abstract: A 42-year-old man was referred for ablation. The origin of VT was localized close to the right coronary ostium. During ablation, the catheter tip inadvertently fell into a RCA ostium. The patient developed chest discomfort and ST-segment elevation in the inferior leads was observed. Coronary angiography confirmed severe narrowing of the ostial RCA. Stenting was deferred after satisfactory dilatation by a balloon. The patient discharged with eventless clinical course afterward. Follow-up coronary angiographic, FD-OCT, IVUS, and iMap examinations were performed at 3, 6, and 15 months after index procedure. The lesion showed progressive positive remodeling associated with intimal proliferation, medial thickening, and lumen narrowing up to 6 months. The patient underwent stenting at 15 months after the index procedure. The lesion required high-pressure post dilatation to obtain optimal stent expansion.
authors.affiliation: Department of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital, Manabeshin-machi 11-7, Tsuchiura, Ibaraki, 300-0053, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Araki
authors.affiliation: Department of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital, Manabeshin-machi 11-7, Tsuchiura, Ibaraki, 300-0053, Japan.
authors.forename: Tetsumin
authors.initials: T
authors.lastname: Lee
authors.affiliation: Department of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital, Manabeshin-machi 11-7, Tsuchiura, Ibaraki, 300-0053, Japan.
authors.forename: Tadashi
authors.initials: T
authors.lastname: Murai
authors.affiliation: Department of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital, Manabeshin-machi 11-7, Tsuchiura, Ibaraki, 300-0053, Japan. kaz@joy.email.ne.jp.
authors.forename: Tsunekazu
authors.initials: T
authors.lastname: Kakuta
mesh_terms: D000328:Adult; D017115:Catheter Ablation / Q000379:methods*; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000601:surgery*; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D008297:Male; D062645:Percutaneous Coronary Intervention; D041623:Tomography, Optical Coherence / Q000379:methods*; D018084:Ultrasonography, Interventional / Q000379:methods*
keywords: Catheter ablation; Complication; Coronary artery injury; FD-OCT; IVUS; PCI