Coronary Pleating Mimicking Coronary Ruptures, Dissections, and Thrombi on Optical Coherence Tomography.

Patient 1 An 84-year-old woman with severe aortic stenosis was referred for coronary angiography before transcatheter aortic valve implantation. A severe stenosis in the mid segment of the right coronary artery was treated with a bare metal stent. The guidewire induced a new moderate focal lesion at the most proximal segment of this vessel (Figure 1A). OCT revealed images consistent with a ruptured plaque with a large cavity adjacent to a normal coronary wall and also images suggesting a large lipid plaque (Figure 1B–1E). Once the guidewire was removed, the angiographic pseudostenosis completely disappeared (Figure 1F) confirming the occurrence of an accordion effect.