Figure 1.

Serial coronary angiogram (upper panel) and optical coherence tomography images (lower panel). (A) Initial coronary angiography (CAG) revealed mild stenosis (dashed line) in the left anterior descending (LAD) coronary artery. Optical coherence tomography (OCT) revealed intracoronary thrombus (arrow) overlying a fibrous plaque with an intact fibrous cap, which was suggestive of OCT-defined plaque erosion as the culprit plaque phenotype. The minimal lumen area was preserved (5.12 mm²). (B) On the acetylcholine provocation test, subtotal stenosis was provoked after intracoronary administration of 100 μg of acetylcholine into the left coronary artery. OCT showed reduction of the thrombus volume in the proximal LAD coronary artery. (C) Follow-up CAG confirmed no significant progression of stenosis in the LAD coronary artery. OCT exhibited formation of a layered plaque.