BACKGROUND A woven coronary artery is a rare congenital coronary anomaly and incidentally found in coronary angiogram. Coronary angiography is the major diagnostic modality, which shows the main trunk of coronary divides into several channels which later reconnect with normal blood flow (J Int Cardiol 113:121-123 2006). However, some cases and reviews inferred that this characteristic might be mimicked by recanalized coronary thrombus, which occurs following thrombotic occlusion. In some case, the multiple intraluminal channels have a 'Swiss cheese', a 'Spider web-like', a 'Honeycomb' or a 'Lotus root' appearance and most of them appear in local segment (Int J Cardiol 186: 239-240, 2015). As these images are nonspecific findings, there is no angiographic uniform definition of intracoronary thrombus. More information about the characteristics and the development of this woven-like structure is needed. CASE PRESENTATION A 67-year-old male patient was admitted to our hospital because of chest pain. Coronary artery angiogram revealed that the right coronary artery (RCA) divided into multiple thin channels from proximal to distal, which was similar to the so-called woven coronary artery. Compared with his prior coronary angiograms which showed a tiny hazy lesion in distal segment of RCA, we found the woven-like phenomena should be caused by a late-stage recanalized coronary thrombus. Percutaneous coronary intervention (PCI) was performed to restore the RCA flow, and the angina symptom was extremely improved during clinical follow-up. CONCLUSIONS The diagnostic criteria of woven coronary artery was based on angiographic image. However, some cases and reviews inferred that thrombotic recanalization might also share the same characteristic. In this case, we collected the baseline angiograms and intracoronary images then successfully diagnosed the woven-like RCA as thrombotic recanalization. For this kind of woven-like coronary artery, PCI could be a better treatment strategy. Detailed history collection and intracoronary image techniques should be emphasized in future clinical practice in the differentiating and treatment of woven-like phenomena.

中文翻译：

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冠状动脉内血栓再通后的机织样变化：病例报告。

背景技术冠状动脉编织是一种罕见的先天性冠状动脉异常，偶然发现于冠状动脉造影中。冠状动脉造影是主要的诊断方式，显示冠状动脉的主要干线分为多个通道，这些通道随后与正常血流重新连接（J Int Cardiol 113：121-123 2006）。但是，一些案例和评论推断，这一特征可能是由再通的冠状动脉血栓模仿的，后者在血栓闭塞后发生。在某些情况下，多个腔内通道具有“瑞士奶酪”，“蜘蛛网状”，“蜂窝状”或“莲花根”外观，并且大多数出现在局部区域中（Int J Cardiol 186：239- 240，2015）。由于这些图像是非特异性发现，因此没有冠状动脉内血栓的血管造影统一定义。需要有关这种编织状结构的特性和发展的更多信息。病例介绍一名67岁的男性患者因胸痛入院。冠状动脉血管造影显示，右冠状动脉（RCA）从近端到远端分成多个细通道，类似于所谓的编织冠状动脉。与他先前的RCA远端段出现细微的雾状病变的冠状动脉造影相比，我们发现编织样现象应由晚期再通的冠状动脉血栓引起。进行了经皮冠状动脉介入治疗（PCI）以恢复RCA血流，临床随访期间心绞痛症状得到极大改善。结论编织冠状动脉的诊断标准基于血管造影图像。然而，一些案例和评论推断，血栓再通可能也具有相同的特征。在这种情况下，我们收集了基线血管造影照片和冠状动脉内图像，然后成功地将机织状RCA诊断为血栓再通。对于这种编织状冠状动脉，PCI可能是一种更好的治疗策略。在将来的临床实践中，应在区分和处理编织样现象时强调详细的病史收集和冠状动脉内成像技术。