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Figure 3 Initial (A, B) and follow-up (C, D) angiograms of the left coronary artery obtained in the right anterior oblique projection. (A) Intracoronary injection of 50 µg acetylcholine (ACh) induced occlusive spasm at the site of severe stenosis (arrow). (B) After intracoronary injection of isosorbide dinitrate (ISDN), severe organic stenosis was present at the proximal left anterior descending coronary artery (arrow). (C) Intracoronary injection of 50 µg ACh induced subocclusive spasm at the edge of the stent (arrowhead) in the left anterior descending coronary artery, as well as occlusive spasm in the proximal left circumflex coronary artery; the stented portion at the site of the initial stenosis (arrow) was free of vasoconstriction. (D) After intracoronary injection of ISDN, there was no restenosis at the initial stenosis (arrow) that had been dilated by intracoronary stenting.
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