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CORONARY - Complications
A Case of Large Hematoma Formation During OFDI Guided PCI
Seiji Kano1, Kenya Nasu1, Maoto Habara1, Takahiko Suzuki1
Toyohashi Heart Center, Japan1,
[Clinical Information]
- Patient initials or identifier number:
-Relevant clinical history and physical exam:
A 50s old man, he  was admitted for angina ofeffort.   Coronary risk factor were hypertension, dyslipidemia and current smoking.Coronary angiography showed proximal RCA was severe stenosis, mid LAD was moderate stenosis. MRI showed, LV inferior and posterior had ischemia. 
-Relevant test results prior to catheterization:

- Relevant catheterization findings:
Coronary angiography showed proximal RCA was severe stenosis, mid LAD was moderate stenosis. 
[Interventional Management]
- Procedural step:
We started PCI for RCA lesion with OFDI guided. OFDI showed, the lesion had thrombosis, and we started aspiration several times. Although, the coronary flow was not improved.  We could not detected the lesion was thrombus or not. We did aspiration and ballooning again. Next, we changed IVUS guided PCI. The IVUS findings showed, the lesion had coronary dissection. Therefore we used cutting balloon for distal re-entry techinics. Finally, we deployed drug eluting stent, the results was excellent with TIMI3 flow in distal RCA. 
- Case Summary:
OFDI or OCT guided PCI was not different clinical outcome compared IVUS guided PCI. On the other hand,  the diagnosis of the coronary hematoma by OFDI or OCT was not easy. We should consider the OCT or OFDI guided PCI needs flash that can made more large hematoma.  
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