Insights of Optical Coherence Tomography in Renal Artery Fibromuscular Dysplasia in a Patient with Spontaneous Coronary Artery Dissection

Optical Ccoherence Tomography

A 60-year-old woman was admitted for an acute coronary syndrome. Coronary angiography showed a spontaneous coronary artery dissection (SCAD) in the left anterior descending coronary artery (A). A typical image of fibromuscular dysplasia (FMD) was also observed in the right renal artery (B). Optical coherence tomography (OCT) (C) revealed alternating areas of thickening and thinning of the medial layer, corresponding to the typical image of "string of beads" readily identified in the longitudinal reconstruction of the OCT and also in angiography.

A very high prevalence of FMD in non-coronary arteries has been recently reported in patients with DCE. Our findings suggest that OCT may provide unique diagnostic clues in these challenging patients.

Figure 1
Panel A: Coronary angiography showing a linear filling defect in left anterior descending coronary artery, corresponding with the SCAD (arrows). Panel B: Renal artery angiography disclosing the typical image of FMD (arrows). Panel C: OCT of renal the artery depicting the characteristic areas of thickening (asterisks) and thinning (arrows) of the middle layer.

• Sources of Funding
  There were no external funding sources for this study.
• Author contributions
  Conception and design of the research, Acquisition of data, Analysis and interpretation of the data and Critical revision of the manuscript for intellectual content: Bastante T, Alfonso F; Writing of the manuscript: Bastante T.
• Study Association
  This study is not associated with any thesis or dissertation work.

Publication Dates

• Publication in this collection
  July 2014

History

• Received
  18 Mar 2014
• Reviewed
  04 Apr 2014
• Accepted
  04 Apr 2014