Heart Views

A PICTURE IS WORTH A THOUSAND WORDS
Year
: 2019  |  Volume : 20  |  Issue : 1  |  Page : 32--33

Optical coherence tomography and intravascular ultrasound in diagnosis of coronary intramural hematoma


Deep Chandh Raja, Vijayakumar Subban, Nandhini Livingston, Jose Thenpally, Ajit S Mullasari 
 Department of Cardiology, Madras Medical Mission, Chennai, Tamil Nadu, India

Correspondence Address:
Dr. Deep Chandh Raja
Department of Cardiology, Institute of Cardio-vascular Disease, Madras Medical Mission, 4-A, Dr. J. Jayalalitha Nagar, Mogappair, Chennai - 600 037, Tamil Nadu
India




How to cite this article:
Raja DC, Subban V, Livingston N, Thenpally J, Mullasari AS. Optical coherence tomography and intravascular ultrasound in diagnosis of coronary intramural hematoma.Heart Views 2019;20:32-33


How to cite this URL:
Raja DC, Subban V, Livingston N, Thenpally J, Mullasari AS. Optical coherence tomography and intravascular ultrasound in diagnosis of coronary intramural hematoma. Heart Views [serial online] 2019 [cited 2021 Sep 25 ];20:32-33
Available from: https://www.heartviews.org/text.asp?2019/20/1/32/257795


Full Text



Intramural hematoma (IMH) tends to occur in a fibrous plaque secondary to balloon dilatation or stent implantation. They are one of the important causes of unexplained deterioration in coronary flows during percutaneous coronary interventions. These IMHs are barely visible on routine coronary angiograms. In an optical coherence tomography (OCT) image, they give rise to a double-lumen appearance with a glistening intimomedial membrane separating the false and the true lumen [Figure 1].{Figure 1}

OCT may not reveal the extramural extent of IMH, which is better visualized in intravascular ultrasound (IVUS), where the IMH appears as an echogenic crescent-shaped blood collection in the extravascular space between the internal and external elastic membrane [Figure 2].{Figure 2}

In addition to the extent of the IMH, the entry and exit sites can be studied with IVUS as well as OCT. Such IMHs need to be addressed with stents of sufficient length to cover the entire extent of the IMH.[1]

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1Maehara A, Mintz GS, Bui AB, Castagna MT, Walter OR, Pappas C, et al. Incidence, morphology, angiographic findings, and outcomes of intramural hematomas after percutaneous coronary interventions: An intravascular ultrasound study. Circulation 2002;105:2037-42.