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Case Report

Severe Negative Remodeling at the Middle Right Coronary Artery without Atheroma Plaque

Kyung Yoon Chang, Kyung Seon Park, Yoo A Choi, Ji Hee Kim, Bu Seok Jeon, Sung Ho Her
The Ewha Medical Journal 2012;35(1):65-68. Published online: March 31, 2012

Division of Cardiology, Department of Internal Medicine, Daejeon St. Mary's Hospital, The Catholic University of Korea School of Medicine, Daejeon, Korea.

Corresponding author: Sung Ho Her, Division of Cardiology, Department of Internal Medicine, Daejeon St. Mary's Hospital, The Catholic University of Korea School of Medicine, 64 Daeheung-ro, Jung-gu, Daejeon 301-723, Korea. Tel: 82-42-220-9504, Fax: 82-42-253-9505, hhhsungho@catholic.ac.kr
• Received: January 20, 2012   • Accepted: February 28, 2012

Copyright © 2012. Ewha Womans University School of Medicine

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Arterial remodeling is commonly observed in human atherosclerosis. It is a heterogeneous response ranging from positive remodeling to negative remodeling. Negative remodeling is a condition in which the vessel area decreases in size, often as a result of a structural change in the coronary vessel wall. But its contribution to myocardial ischemia in a de novo lesion has not been clearly shown. A 51-year-old female with exertional angina was admitted to our hospital. Coronary angiography was performed, revealing a severe stenosis at the middle part of the right coronary artery (RCA). Although we predilated ballooning at the middle RCA, the degree of stenosis did not improve. Thus intravascular ultrasound (IVUS) was performed. The lesion was not nearly showed plaque burden and severe negative remodeling. Though the cross-sectional narrowing percentage was significant, we decided to medical treatment for fearing coronary perforation by stenting. This case report intends to emphasize that severe coronary stenosis should be performed IVUS before the stenting. We describe a rare case with severe negative remodeling at the middle part of the RCA without atheroma plaque.
  • Keywords: Angina; Atherosclerosis; Ultrasound, intravascular; Negative remodeling
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Fig. 1
Exercise treadmill test was positive by typical angina at 4.6 METs.
emj-35-65-g001.jpg
Fig. 2
Right coronary angiogram revealed a severe stenosis at the middle part of the right coronary artery (arrow).
emj-35-65-g002.jpg
Fig. 3
Intravascular ultrasound was showed severe negative remodeling (B) without atheroma plaque compared to the proximal and distal site (A, C).
emj-35-65-g003.jpg
Table 1
Cases of negative remodeling

IVUS, intravascular ultrasound; LCx, left circumflex artery; LAD, left anterior descending artery; RCA, right coronary artery; MI, myocardial infarction.

emj-35-65-i001.jpg

Figure & Data

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    • Extreme negative remodeling of septal left anterior descending branch masquerading as a bifurcation lesion
      Ajith Ananthakrishna Pillai, Sasinthar Rangasamy
      The International Journal of Cardiovascular Imaging.2019; 35(4): 597.     CrossRef

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    Severe Negative Remodeling at the Middle Right Coronary Artery without Atheroma Plaque
    Ewha Med J. 2012;35(1):65-68.   Published online March 31, 2012
    DOI: https://doi.org/10.12771/emj.2012.35.1.65
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    Severe Negative Remodeling at the Middle Right Coronary Artery without Atheroma Plaque
    Ewha Med J. 2012;35(1):65-68.   Published online March 31, 2012
    DOI: https://doi.org/10.12771/emj.2012.35.1.65
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    Severe Negative Remodeling at the Middle Right Coronary Artery without Atheroma Plaque
    Image Image Image
    Fig. 1 Exercise treadmill test was positive by typical angina at 4.6 METs.
    Fig. 2 Right coronary angiogram revealed a severe stenosis at the middle part of the right coronary artery (arrow).
    Fig. 3 Intravascular ultrasound was showed severe negative remodeling (B) without atheroma plaque compared to the proximal and distal site (A, C).

    Fig. 1

    Fig. 2

    Fig. 3

    Severe Negative Remodeling at the Middle Right Coronary Artery without Atheroma Plaque

    Cases of negative remodeling

    IVUS, intravascular ultrasound; LCx, left circumflex artery; LAD, left anterior descending artery; RCA, right coronary artery; MI, myocardial infarction.
    Table 1 Cases of negative remodeling

    IVUS, intravascular ultrasound; LCx, left circumflex artery; LAD, left anterior descending artery; RCA, right coronary artery; MI, myocardial infarction.

    Table 1

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