A honeycomb-like structure in the left anterior descending coronary artery treated using a scoring device and drug-eluting stent implantation: a case report

BACKGROUND: A honeycomb-like structure in the coronary artery is rarely diagnosed by intracoronary ultrasound or optical coherence tomography. Further, its structural mechanisms and response to interventional therapy remain unknown. CASE PRESENTATION: A 59-year-old Japanese man was referred to our hospital because of acute decompensated heart failure with rapid atrial fibrillation. After receiving anticoagulant therapy, a coronary angiogram revealed a braid-like appearance and an intracoronary ultrasound image confirmed a honeycomb-like structure in the mid left anterior descending coronary artery. We inserted two guide wires into different partitions. Although a balloon angioplasty with a scoring device could not completely fenestrate these partitions, a stent implant was able to completely compress the structure easily. CONCLUSIONS: The honeycomb-like structure of the left anterior descending coronary artery in our patient was suspected to be because of recanalization of a cardiogenic embolism. This structure may have been composed of relatively hard tissues, but was easily compressed by a stent implantation.