ABSTRACT
Figures 16.1 and 16.2 illustrate the clinical dilemma with the impossibility to predict a plaque rupture of angiographically non-significant lesions, even while exhausting pharmacological plaque passivation. Figure 16.1 shows the angiograms of a 60-year-old male with multiple risk factors (cigarette smoking, hypertension, hypercholesterolemia and positive family history). He first came to our catheterization laboratory after a non-ST-elevation MI. The first diagonal branch was recanalized and stented. The LAD (left anterior descending artery) showed
(a) (b)
(c) (d) Figure 16.1 (a) Angiogram of the left coronary artery prior to the first intervention with an occluded first diagonal branch (black arrow) and a non-significant plaque in the mid left anterior descending (LAD) artery (white arrow). (b) Post intervention. (c) Acute reangiography five months later for an occluded LAD (white arrow) with patent diagonal branch (black arrow). (d) After successful intervention with both vessels patent.
