Honeycomb or Lotus Root‐Like Intracoronary Pattern: Insights From Optical Coherence Tomography of a Recanalized Thrombus
Bibliographic record
Abstract
Spontaneous recanalized coronary thrombus (SRCT) has been identified in autopsy studies as multiple interconnected channels separated by thin septa. Despite its potential clinical significance, SRCT remains underdiagnosed. Recent advances in intracoronary imaging, including optical coherence tomography (OCT), have elucidated its pathophysiology, angiographic patterns, and therapeutic strategies. This review summarizes the epidemiological data, angiographic and OCT features, histopathological correlations, physiopathology, and interventional strategies for SRCT. A comprehensive literature review was performed, including data from dedicated registries and studies employing advanced intracoronary imaging modalities. Patients with SRCT are predominantly men in their fifth decade of life with cardiovascular risk factors and a history of acute or chronic coronary syndromes. Angiographic findings frequently include a braid-like or hazy appearance with TIMI 3 distal flow. OCT imaging reveals honeycomb-like patterns of multiple microchannels divided by fibrous septa. Histopathology corroborates these findings, highlighting organized thrombus with endothelialized septa and atherosclerotic features. Functional assessments indicate that most lesions are hemodynamically significant (FFR < 0.8). Treatment strategies include drug-eluting stents (DES) and drug-coated balloons, with post-procedural OCT confirming lesion resolution. Challenges include side branch occlusion during an intervention, necessitating specific technical considerations to mitigate risks. SRCT is a distinct pathological and imaging entity characterized by multiple communicating channels. Advanced imaging and physiological assessment are pivotal for accurate diagnosis and management. DES remains the cornerstone of treatment, but procedural planning must address the risk of side branch occlusion. Further studies are warranted to explore long-term outcomes and optimize therapeutic approaches.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.008 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".