{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T15:49:02Z","timestamp":1753890542877,"version":"3.41.2"},"reference-count":12,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,2,25]],"date-time":"2022-02-25T00:00:00Z","timestamp":1645747200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"Background<\/jats:title>Intravascular imaging plays a vital role in the pathophysiology-based diagnosis and treatment of patients with ST-elevation myocardial infarction (STEMI). We present a case of STEMI due to plaque erosion, which was managed with a no stent approach.<\/jats:p><\/jats:sec>Case Summary<\/jats:title>A 43-year-old female with a history of tobacco abuse presented with an anterior STEMI. Coronary angiography revealed acute thrombotic occlusion of the left anterior descending artery with spontaneous recanalization. Intravascular imaging with optical coherence tomography (OCT) demonstrated plaque erosion as the underlying etiology for the acute thrombotic occlusion. A no stent strategy with aspiration thrombectomy and dual antiplatelet therapy was used to manage the patient given that there was no evidence of plaque rupture. Repeat coronary imaging was done at 2 months to assess the status of the lesion.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>A 43-year-old female with STEMI due to plaque erosion was successfully managed only by thrombus aspiration and not by angioplasty and stent placement. Individualized treatment approaches in patients with acute coronary syndromes, can not only achieve optimal management goals but also avoid unnecessary complications associated with interventions. This case illustrates how intracoronary imaging and pathophysiology-guided treatment can dramatically change management. In this young patient, STEMI was managed purely by thrombus aspiration. Intravascular imaging obviated the need for stent placement possibly preventing stent-related complications including restenosis and thrombosis.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcvm.2022.834676","type":"journal-article","created":{"date-parts":[[2022,2,25]],"date-time":"2022-02-25T06:46:15Z","timestamp":1645771575000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: ST-Elevation Myocardial Infarction Secondary to Acute Atherothrombotic Occlusion Treated With No Stent Strategy"],"prefix":"10.3389","volume":"9","author":[{"given":"Rahul","family":"Dhawan","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saurabhi","family":"Samant","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ganesh","family":"Gajanan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yiannis S.","family":"Chatzizisis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,2,25]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1166","DOI":"10.1016\/j.jcin.2015.02.026","article-title":"A combined optical coherence tomography and intravascular ultrasound study on plaque rupture, plaque erosion, and calcified nodule in patients with st-segment elevation myocardial infarction: incidence, morphologic characteristics, and outcomes after percutaneous coronary intervention","volume":"8","author":"Higuma","year":"2015","journal-title":"JACC Cardiovasc Interv."},{"key":"B2","doi-asserted-by":"publisher","first-page":"2077","DOI":"10.1093\/eurheartj\/ehy101","article-title":"In vivo predictors of plaque erosion in patients with ST-segment elevation myocardial infarction: a clinical, angiographical, and intravascular optical coherence tomography study","volume":"39","author":"Dai","year":"2018","journal-title":"Eur Heart J."},{"key":"B3","doi-asserted-by":"publisher","first-page":"e005860","DOI":"10.1161\/CIRCINTERVENTIONS.117.005860","article-title":"EROSION study (effective anti-thrombotic therapy without stenting: intravascular optical coherence tomography-based management in plaque erosion): a 1-year follow-up report","volume":"10","author":"Xing","year":"2017","journal-title":"Circ Cardiovasc Interv."},{"key":"B4","doi-asserted-by":"publisher","first-page":"1155","DOI":"10.1161\/CIRCULATIONAHA.117.029870","article-title":"Acute coronary syndromes: the way forward from mechanisms to precision treatment","volume":"136","author":"Crea","year":"2017","journal-title":"Circulation."},{"key":"B5","doi-asserted-by":"publisher","first-page":"792","DOI":"10.1093\/eurheartj\/ehw381","article-title":"Effective anti-thrombotic therapy without stenting: intravascular optical coherence tomography-based management in plaque erosion (the EROSION study)","volume":"38","author":"Jia","year":"2017","journal-title":"Eur Heart J."},{"key":"B6","doi-asserted-by":"publisher","first-page":"e004730","DOI":"10.1161\/JAHA.116.004730","article-title":"Management and outcome of patients with acute coronary syndrome caused by plaque rupture versus plaque erosion: an intravascular optical coherence tomography study","volume":"6","author":"Hu","year":"2017","journal-title":"J Am Heart Assoc."},{"key":"B7","doi-asserted-by":"publisher","first-page":"283","DOI":"10.1016\/j.jcmg.2012.12.007","article-title":"OCT-based diagnosis and management of STEMI associated with intact fibrous cap","volume":"6","author":"Prati","year":"2013","journal-title":"JACC Cardiovasc Imaging."},{"key":"B8","doi-asserted-by":"publisher","first-page":"592","DOI":"10.1002\/ccd.26943","article-title":"Plaque erosion delays vascular healing after drug eluting stent implantation in patients with acute coronary syndrome: an in vivo optical coherence tomography study","volume":"89","author":"Hu","year":"2017","journal-title":"Catheter Cardiovasc Interv."},{"key":"B9","doi-asserted-by":"publisher","first-page":"1041","DOI":"10.3390\/jcm9041041","article-title":"Role of cardiac magnetic resonance to improve risk prediction following acute ST-elevation myocardial infarction","volume":"9","author":"Reindl","year":"2020","journal-title":"J Clin Med."},{"key":"B10","doi-asserted-by":"publisher","first-page":"e012322","DOI":"10.1161\/JAHA.119.012322","article-title":"Clinical and laboratory predictors for plaque erosion in patients with acute coronary syndromes","volume":"8","author":"Yamamoto","year":"2019","journal-title":"J Am Heart Assoc."},{"key":"B11","doi-asserted-by":"publisher","first-page":"1072","DOI":"10.3390\/diagnostics11061072","article-title":"Coronary computer tomography angiography in 2021\u2014acquisition protocols, tips and tricks and heading beyond the possible","volume":"11","author":"Giusca","year":"2021","journal-title":"Diagnostics."},{"key":"B12","unstructured":"JiaH\n EROSION III: A Randomized Trial of OCT-Guided Intervention in STEMI Patients With Early Infarct Artery Patency"}],"container-title":["Frontiers in Cardiovascular Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2022.834676\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,2,25]],"date-time":"2022-02-25T06:46:17Z","timestamp":1645771577000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2022.834676\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,2,25]]},"references-count":12,"alternative-id":["10.3389\/fcvm.2022.834676"],"URL":"https:\/\/doi.org\/10.3389\/fcvm.2022.834676","relation":{},"ISSN":["2297-055X"],"issn-type":[{"type":"electronic","value":"2297-055X"}],"subject":[],"published":{"date-parts":[[2022,2,25]]},"article-number":"834676"}}