ArticleJACC. Case reports2025
Vasospasm-Associated Plaque Erosion: A Case Report With Pathological Confirmation by Directional Coronary Atherectomy.
Article in JACC. Case reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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10 authors.
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Abstract
backgroundPlaque erosion is a significant cause of acute coronary syndromes, representing a distinct pathophysiological entity from plaque rupture. Coronary vasospasm is a suspected trigger for erosion, though its precise mechanisms are not fully understood. Furthermore, reports of its histopathological confirmation by directional coronary atherectomy (DCA) are limited. CASE PRESENTATION: We present the case of a 56-year-old male with organic coronary stenosis and a clinical history suggestive of vasospasm. Intravascular optical coherence tomography revealed features highly suggestive of plaque erosion, including an overlying white thrombus. To obtain a definitive diagnosis, DCA was performed for tissue acquisition. Subsequent histopathological examination of the retrieved specimens clearly confirmed plaque erosion, demonstrating a thrombus adherent to an intact, smooth muscle cell-rich intimal layer without disruption of a fibrous cap.
conclusionsThis case provides DCA-confirmed pathological evidence for the clinically important potential link between coronary vasospasm and plaque erosion.
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