case_images: PMC5396424_01
case_images: (a) Coronary angiogram showing a tight stenosis in proximal left anterior descending artery (culprit lesion shown by red arrow). (b and c) Directional coronary atherectomy (DCA) catheter debulking plaque of the target lesion. Red arrows show the head of DCA cutter, advancing from proximal (b) to distal (c) position of the catheter. Bracket indicates the housing area of the catheter.
case_images: CRIC2017-2397183.001.jpg
case_images: PMC5396424_01_CRIC2017-2397183.001.jpg
case_images: fig1
case_images: A 73-year-old male with effort angina was referred to our hospital, and diagnostic coronary angiography revealed a tight stenosis in proximal left anterior descending artery (LAD) (Figure 1(a)), which demonstrated a fractional flow reserve (FFR) of 0.68. Figures 1(b) and 1(c) show DCA catheter debulking targeted plaque.
case_images: Directional coronary atherectomy-derived plaque (a) and artificial material (b), which was considered as peeled guidewire, approximately 15 mm in length. Some plaques were attached to the material (c and d [magnified image]).
case_images: CRIC2017-2397183.002.jpg
case_images: PMC5396424_01_CRIC2017-2397183.002.jpg
case_images: fig2
case_images: After 7 sessions of debulking, white plaques accompanied by green, stringed materials were obtained from the device (Figure 2). Some extracted artificial materials were considerably large, approximately 15 mm in length (Figure 2(b)); some were clumped and attached to plaques (Figures 2(c)-2(d)).
case_images: Pathological specimen of the peeled guidewire (a) and fragments of the material shown in the plaque (b). There are no inflammatory findings on plaque adjacent to the material.
case_images: CRIC2017-2397183.003.jpg
case_images: PMC5396424_01_CRIC2017-2397183.003.jpg
case_images: fig3
case_images: The extracted plaques and artificial materials were pathologically examined (Figure 3).