Role of Integrated Intracoronary Imaging to Identify Surgical Clip as a Trigger for ACS-NSTE

Giuseppe Panuccio, MD, PhD; Salvatore De Rosa, MD, PhD; Ulf Landmesser, MD; David M. Leistner, MD; Youssef S. Abdelwahed, MD

JACC: Case Reports (Jan 2024)

Role of Integrated Intracoronary Imaging to Identify Surgical Clip as a Trigger for ACS-NSTE

Giuseppe Panuccio, MD, PhD,
Salvatore De Rosa, MD, PhD,
Ulf Landmesser, MD,
David M. Leistner, MD,
Youssef S. Abdelwahed, MD

Affiliations

Giuseppe Panuccio, MD, PhD: Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy; Department of Cardiology, Angiology, and Intensive Care Medicine, Charité German Heart Center Berlin, Berlin, Germany; Address for correspondence: Dr Giuseppe Panuccio, Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Viale Europa, Catanzaro 88100, Italy.
Salvatore De Rosa, MD, PhD: Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy
Ulf Landmesser, MD: Department of Cardiology, Angiology, and Intensive Care Medicine, Charité German Heart Center Berlin, Berlin, Germany; German Centre for Cardiovascular Research, Berlin, Germany; Berlin Institute of Health, Berlin, Germany
David M. Leistner, MD: Division of Cardiology, Department of Medicine, Goethe University Hospital, Frankfurt, Germany; German Center for Cardiovascular Research Partner Site RheinMain, Frankfurt, Germany
Youssef S. Abdelwahed, MD: Department of Cardiology, Angiology, and Intensive Care Medicine, Charité German Heart Center Berlin, Berlin, Germany; German Centre for Cardiovascular Research, Berlin, Germany

Journal volume & issue: Vol. 29, no. 1
p. 102152

Abstract

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An 80-year-old post–coronary artery bypass graft (CABG) patient had an acute coronary syndrome with non–ST-segment elevation myocardial infarction (ACS-NSTE) with saphenous vein graft (SVG)–obtuse marginal stenosis. High-definition intravascular ultrasound revealed an underexpanded SVG stent with a hyperechoic structure. Optical coherence tomography confirmed surgical clip causing compression, resolved by post-dilation. This case underscores ACS-NSTE complexity post-CABG and the critical role of coronary imaging in optimizing interventions by addressing surgical clip–induced compression.

Published in JACC: Case Reports

ISSN: 2666-0849 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the circulatory (Cardiovascular) system
Website: https://www.journals.elsevier.com/jacc-case-reports

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