biostudies-literatureMoriya SJSPS KAKENHIGrant-in-Aid for Scientific Research1-5https://www.ebi.ac.uk/biostudies/studies/S-EPMC7780494biostudies-literatureUnknown4(4)<h4>Background</h4>Near-infrared spectroscopy (NIRS) has been used for analysis the composition of the atherosclerotic plaque in coronary arteries. However, meaning of significant decrease in max lipid core burden index at 4 mm (max LCBI_4mm) during percutaneous coronary intervention (PCI) is poorly understood.<h4>Case summary</h4>A 64-year-old male with unstable angina underwent coronary angiography, which demonstrated a hazy tight culprit lesion in the mid-right coronary artery. Pre-intervention NIRS-intravascular ultrasound (NIRS-IVUS) and chemogram showed plaque with high lipid burden at the culprit lesion. Then, we used a distal protection device before PCI because of high max LCBI_4mm in the lesion. After pre-dilation with a scoring balloon, repeat NIRS-IVUS interEuropean heart journal. Case reportsSignificant decrease in lipid core burden index following balloon dilation was associated with the leakage of cholesterol crystals in a patient: a case report.PMC778049420K0843316K09522Moriya SIsoda KDohi TOkazaki SfalseSignificant decrease in lipid core burden index following balloon dilation was associated with the leakage of cholesterol crystals in a patient: a case report.<h4>Background</h4>Near-infrared spectroscopy (NIRS) has been used for analysis the composition of the atherosclerotic plaque in coronary arteries. However, meaning of significant decrease in max lipid core burden index at 4 mm (max LCBI_4mm) during percutaneous coronary intervention (PCI) is poorly understood.<h4>Case summary</h4>A 64-year-old male with unstable angina underwent coronary angiography, which demonstrated a hazy tight culprit lesion in the mid-right coronary artery. Pre-intervention NIRS-intravascular ultrasound (NIRS-IVUS) and chemogram showed plaque with high lipid burden at the culprit lesion. Then, we used a distal protection device before PCI because of high max LCBI_4mm in the lesion. After pre-dilation with a scoring balloon, repeat NIRS-IVUS inter2020-01-01T00:00:00Z2020 Aug2025-04-22T08:15:13.387Z2022-02-10T15:42:56.32ZS-EPMC77804943415113910.1093/ehjcr/ytaa148