Angioscopic observation of an atherosclerotic coronary aneurysm without yellow plaque

Description

A-58-year-old man with diabetes mellitus was admitted to our hospital with angina following physical effort. Coronary CT angiography (CCTA) revealed a saccular coronary aneurysm at the left main trunk bifurcation and a significant stenosis at the middle portion of the calcified left anterior descending artery (LAD) (figure 1). Invasive coronary angiography showed a large coronary aneurysm (12.3x11.0 mm) arising from the ostial LAD and stenoses in the middle of the LAD and in the middle of the left circumflex artery (figure 2). Intravascular ultrasound showed a severely calcified LAD, as shown on CCTA; however, it failed to reveal the entire picture with regard to the aneurysm because of the limited echo depth. Non-obstructive angioscopy (NOA)1 was performed to investigate the intimal injury of the aneurysm and demonstrated a rough, salmon-pink coloured surface without the presence of thrombus or atheromatous yellow plaque

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