The Role of Comprehensive Hybrid Imaging in Identification of Plaque Rupture and Ostial Stent Placement: Case Report

Abstract

A 52-year-old male smoker with multiple risk factors (hypertension, hyperlipidemia, type 2 diabetes mellitus, and end-stage renal disease treated with dialysis), exertional angina, and inferior ischemia was referred for angiography. He was found to have an ostial right coronary artery (RCA) lesion that was thought to be calcified based on angiography. Hybrid imaging was performed with intravenous ultrasound (IVUS) and optical coherence tomography (OCT) using the Novasight Hybrid IVUS-OCT System catheter (Conavi Medical), which helped identify plaque rupture as opposed to calcification. OCT, with its superior resolution, demonstrated plaque rupture that was difficult to appreciate on IVUS. IVUS was used to mark the ostium of the RCA and precisely place a stent in the ostial RCA.