title: A honeycomb-like structure in the left anterior descending coronary artery treated using a scoring device and drug-eluting stent implantation: a case report.
abstract: BACKGROUND
  A honeycomb-like structure in the coronary artery is rarely diagnosed by intracoronary ultrasound or optical coherence tomography. Further, its structural mechanisms and response to interventional therapy remain unknown.
  
  
  METHODS
  A 59-year-old Japanese man was referred to our hospital because of acute decompensated heart failure with rapid atrial fibrillation. After receiving anticoagulant therapy, a coronary angiogram revealed a braid-like appearance and an intracoronary ultrasound image confirmed a honeycomb-like structure in the mid left anterior descending coronary artery. We inserted two guide wires into different partitions. Although a balloon angioplasty with a scoring device could not completely fenestrate these partitions, a stent implant was able to completely compress the structure easily.
  
  
  CONCLUSIONS
  The honeycomb-like structure of the left anterior descending coronary artery in our patient was suspected to be because of recanalization of a cardiogenic embolism. This structure may have been composed of relatively hard tissues, but was easily compressed by a stent implantation.
authors.affiliation: Department of Cardiology, Saitama Eastern Cardiovascular Hospital, Osawa 3187-1, Koshigaya, 343-0025, Saitama, Japan. tatsuo.haraki@gmail.com.
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Haraki
authors.affiliation: Department of Cardiology, Saitama Eastern Cardiovascular Hospital, Osawa 3187-1, Koshigaya, 343-0025, Saitama, Japan.
authors.forename: Ryota
authors.initials: R
authors.lastname: Uemura
authors.affiliation: Department of Cardiology, Saitama Eastern Cardiovascular Hospital, Osawa 3187-1, Koshigaya, 343-0025, Saitama, Japan.
authors.forename: Shin-ichiro
authors.initials: S
authors.lastname: Masuda
authors.affiliation: Department of Cardiology, Saitama Eastern Cardiovascular Hospital, Osawa 3187-1, Koshigaya, 343-0025, Saitama, Japan.
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Kobayashi
authors.affiliation: Department of Cardiology, Saitama Eastern Cardiovascular Hospital, Osawa 3187-1, Koshigaya, 343-0025, Saitama, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Lee
mesh_terms: D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D001281:Atrial Fibrillation / Q000209:etiology / Q000628:therapy; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D054855:Drug-Eluting Stents; D004452:Echocardiography; D005343:Fibrinolytic Agents / Q000008:administration & dosage; D006333:Heart Failure / Q000209:etiology / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D011720:Pyrazoles / Q000008:administration & dosage; D011728:Pyridones / Q000008:administration & dosage; D013923:Thromboembolism / Q000150:complications; D018084:Ultrasonography, Interventional
chemical_list: D005343:Fibrinolytic Agents; D011720:Pyrazoles; D011728:Pyridones; C522181:apixaban
keywords: Apixaban; Coronary artery; Honeycomb-like structure; Scoring devices; Stent implantation