Open AccessIntraluminal Filling Defects on Coronary Angiography: More than Meets the Eye
Author(s) -
Jaffe Ronen,
Irfan Affan,
Hong Tony,
Chisholm Robert J.,
Cheema Asim N.
Publication year - 2007
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.20062
Subject(s) - medicine , intravascular ultrasound , percutaneous coronary intervention , coronary angiography , radiology , thrombus , conventional pci , cardiology , angiography , artery dissection , dissection (medical) , coronary arteries , calcification , artery , myocardial infarction
Intraluminal filling defects are occasionally encountered on coronary angiography and often related with coronary thrombi. However, other conditions affecting the coronary arteries may present with similar angiographic findings causing diagnostic uncertainty. Accurate characterization of the angiographic filling defect is critical, particularly in patients planned for a percutaneous coronary intervention (PCI), as diagnosis of a coronary thrombus not only increases the risk of post procedural adverse events but also requires a specific therapeutic approach. In this paper, we report three patients in whom coronary angiography revealed intraluminal filling defects mimicking coronary thrombi. When further investigated with intravascular ultrasound (IVUS) as a part of the planned PCI, the thrombus was excluded and alternate etiology of the filling defect was confirmed in all patients. The angiographic “pseudothrombi” were produced by coronary dissection in one and by heavy calcification within the atherosclerotic plaque in two patients. The use of IVUS allowed accurate characterization of the angiographic filling defect and provided important information to guide management and optimize therapeutic approach. Copyright © 2007 Wiley Periodicals, Inc.