A 47-year-old patient underwent elective percutaneous coronary intervention for two separate lesions in left circumflex artery with a intervening normal segment. After completion of the procedure, there was abrupt vessel closure in the intervening normal segment. Intracoronary imaging using optical coherence tomography (OCT) demonstrated a large intramural hematoma (IMH) extending distally behind the stent. We describe the OCT findings of IMH using cross-sectional, longitudinal and stent-rendered images, and discuss its management.
Keywords: Abrupt closure; Complication; Coronary dissection; Intracoronary imaging; Intramural hematoma; Optical coherence tomography; Percutaneous coronary intervention.
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