{
  "abstract": "Background: The no-reflow phenomenon during percutaneous coronary intervention (PCI) is commonly associated with distal embolization from high-risk coronary plaques, including lesions with intravascular ultrasound (IVUS)-defined attenuation. Histopathological analysis of embolic debris captured during PCI is rarely reported and may provide additional insights into the relationship between plaque characteristics and coronary flow outcomes.\n\nCase summary: An 84-year-old man presented with acute coronary syndrome and decompensated heart failure. Coronary angiography demonstrated severe multi-vessel coronary artery disease, including a long right coronary artery lesion with extensive IVUS attenuation. Given the high risk of distal embolization, PCI was performed using a distal protection device. Drug-eluting stents were successfully implanted, and Thrombolysis In Myocardial Infarction flow grade 3 was maintained throughout the procedure without slow flow or no reflow. Histopathological examination of debris captured by the distal protection device demonstrated predominantly fibrin- and collagen-rich thrombotic material with macrophage infiltration and no apparent abundant lipid component. The patient experienced an uneventful recovery and was discharged without procedural complications.\n\nDiscussion: The composition of retrieved embolic debris captured during PCI differed from the expected imaging phenotype. This case highlights the potential discrepancy between intracoronary imaging appearance and embolized material and underscores the multifactorial nature of coronary slow flow and no reflow. Careful interpretation of IVUS attenuation and embolic pathology is warranted when assessing procedural risk.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": "case report",
  "arxiv": null,
  "author_total": 3,
  "authors": [
    {
      "name": "Kenta Suzuki"
    },
    {
      "name": "Tomomi Koizumi",
      "orcid": "0000-0001-7984-0755"
    },
    {
      "name": "Yukinori Inadome"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/1vsve1atpddva.bib",
  "cited_by": 0,
  "doi": "10.1093/ehjcr/ytag739",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13738071/",
  "id": "1vsve1atpddva",
  "issns": [
    "2514-2119"
  ],
  "landing_url": "https://doi.org/10.1093/ehjcr/ytag739",
  "language": "en",
  "licence": "CC-BY-NC-4.0",
  "licence_label": "CC BY-NC 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "AcademicSubjects/MED00200"
    ],
    [
      "heading",
      "Case Report"
    ],
    [
      "heading",
      "Coronary Intervention"
    ],
    [
      "heading",
      "Eurheartj/39"
    ],
    [
      "heading",
      "Eurheartj/41"
    ],
    [
      "openalex",
      "2705|Coronary Interventions and Diagnostics"
    ]
  ],
  "openalex": "W7220929096",
  "pdf_url": "https://academic.oup.com/ehjcr/advance-article-pdf/doi/10.1093/ehjcr/ytag739/71684603/ytag739.pdf",
  "pmcid": "PMC13738071",
  "pmid": "42992102",
  "published": "2026-10-08",
  "publisher": "Oxford University Press",
  "ris": "https://research.draconitic.com/paper/1vsve1atpddva.ris",
  "sources": [
    {
      "first_seen": "2026-11-09T12:23:08Z",
      "native_id": "PMC13738071",
      "source": "pmc",
      "url": "https://doi.org/10.1093/ehjcr/ytag739"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2705|Coronary Interventions and Diagnostics",
      "subfield": "cardiovascular"
    }
  ],
  "title": "Long IVUS-attenuated plaque without no-reflow: histological findings of captured embolic debris and implications for the interpretation of IVUS attenuation: a case report",
  "title_text": "Long IVUS-attenuated plaque without no-reflow: histological findings of captured embolic debris and implications for the interpretation of IVUS attenuation: a case report",
  "type": "peer-reviewed",
  "updated_at": "2026-11-09T12:23:08Z",
  "url": "https://research.draconitic.com/paper/1vsve1atpddva",
  "venue": "European Heart Journal. Case Reports",
  "versions": []
}