Characterization and morphology of atherosclerotic plaque of coronary arteries: Utility of electron-beam tomography to detect non-calcified plaque: A comparison with conventional coronary angiography and intravascular ultrasound

2007 ◽  
Vol 115 (1) ◽  
pp. 108-113 ◽  
Author(s):  
Nobusada Funabashi ◽  
Kazuo Misumi ◽  
Hiroyuki Ohnishi ◽  
Miki Asano ◽  
Issei Komuro
Keyword(s):  
Electron Beam ◽  
Coronary Angiography ◽  
Intravascular Ultrasound ◽  
Coronary Arteries ◽  
Atherosclerotic Plaque ◽  
Conventional Coronary Angiography ◽  
Electron Beam Tomography ◽  
Calcified Plaque

Abstract 681: Characteristics of Atherosclerotic Plaque Burden in Patients With and Without Acute Coronary Syndrome Presenting With Acute Chest Pain to the Emergency Department

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Fabian Bamberg ◽  
Maros Ferecik ◽  
Quynh Truong ◽  
Ian Rogers ◽  
Michael Shapiro ◽  
...  
Keyword(s):  
Emergency Department ◽  
Chest Pain ◽  
Coronary Arteries ◽  
Atherosclerotic Plaque ◽  
Acute Chest Pain ◽  
Coronary Plaque ◽  
Plaque Burden ◽  
Coronary Syndrome ◽  
Coronary Ct ◽  
Calcified Plaque

Background: Coronary computed tomography (CT) may improve the early triage of patients with acute chest pain in the emergency department (ED). The aim of this study was to compare the presence and extent of coronary atherosclerotic plaque as detected by coronary CT in patients with and without acute coronary syndromes (ACS). Methods: The study was designed as a prospective, observational cohort study in patients with acute chest pain but negative cardiac biomarkers and no diagnostic ECG changes, admitted to rule out myocardial ischemia. All patients underwent coronary CT prior to hospital admission. The presence of coronary plaque was treated as a dichotomous outcome, and the extent of CAD was defined as number of (1) coronary segments with plaque, or (2) major coronary arteries with plaque detected by MDCT as assessed by two independent observers. The clinical outcome (ACS) was adjudicated by a review committee using established AHA criteria; subjects with history of CAD (stent placement, bypass) were excluded. Results : Among 368 patients with acute chest pain (mean age 53±12 years, 61% male) 31 patients were determined to have ACS (8%). None of the 183 subjects without plaque (50%) had an ACS. Among the remaining 185 subjects (mean age 58.0±11.5 years, 68% male) in whom coronary plaque was detected, patients with ACS had a significantly more plaque (7.2±3.7 vs. 4.2±3.4, p<0.0001 segments) as compared to subjects without ACS. Similar results were seen for calcified plaque and non-calcified plaque (6.5±3.7 vs. 3.6±3.5 segments, p<0.0001; and 3.6±3.2 vs. 1.8±2.2 segments, p<0.0001, respectively). In addition, the rate of ACS increased with the number of major coronary arteries with plaque (1-vessel: 6.8%, 2-vessels: 10.6%, 3 vessels: 30.8%, and 4-vessels: 25%; p<0.01). In contrast, the ratio of non-calcified to calcified plaque was not different between patients with and without ACS (0.68±0.6 vs. 0.54±0.72, p=0.31). Conclusions: The extent of coronary plaque differs between subjects with and without ACS among patients presenting with acute chest pain. Detailed assessment of the extent and composition of coronary plaque may be helpful to assess risk of ACS among patients with acute chest pain but inconclusive initial ED evaluation.

Magnetic resonance and electron beam tomography coronary angiography

1998 ◽  
pp. 411-418
Author(s):  
Pim J. de Feyter ◽  
Robert-Jan van Geuns ◽  
Peter van Ooijen ◽  
Fons Bongaerts ◽  
Benno Rensing ◽  
...  
Keyword(s):  
Electron Beam ◽  
Magnetic Resonance ◽  
Coronary Angiography ◽  
Electron Beam Tomography

scholarly journals Comparison of detection percentage and morphology of myocardial bridge between conventional coronary angiography and coronary CT angiography

2019 ◽  
Vol 11 (3) ◽  
pp. 203-208
Author(s):  
Seyed Hassan Eftekhar-Vaghefi ◽  
Somayeh Pourhoseini ◽  
Maryam Movahedi ◽  
Shohre Hooshmand ◽  
Mohammad Ali Ostovan ◽  
...  
Keyword(s):  
Coronary Angiography ◽  
Atherosclerotic Plaque ◽  
Conventional Coronary Angiography ◽  
Myocardial Bridge ◽  
Cross Sectional ◽  
Coronary Ct ◽  
Morphologic Characteristics ◽  
Atherosclerotic Plaque Formation ◽  
Significant Difference ◽  
One Year

Introduction: Myocardial bridge (MB) is a congenital anomaly in which a segment of a coronary artery is surrounded by myocardium. In our study, we want to use conventional coronary angiography (CCA) to describe morphologic characteristics of MB (unidentified or identified) in the patients with documented evidence of MB in coronary computed tomography angiography (CCTA). Methods: The present study was designed as cross-sectional and was conducted on 47 patients with documented evidence of MB in CCTA, who were referred to Nemazee and Faghihi hospitals for performing coronary angiography during a one year period. We compared the morphologic characteristics of tunneled segments, which were missed at CCA (unidentified), and the tunneled segments which were identified with CCA. Results: In sum, MB was found in 16 (34%) patients at CCA (identified), and it was not found in 31 (66%) patients (unidentified) based on compression sign. No significant correlation was found between the percentage of systolic compression and the length and depth of the tunneled segment in identified group (r=0.73, P = 0.18; r=1.09, P = 0.15; respectively). Degree of atherosclerotic plaque formation (diameter stenosis, percentage) (mean, 0.25 (25%) ±0.29; range, 0-0.98) of the tunneled segments in unidentified group was significantly more than the same degree (mean, 0.07 (7%) ±0.13; range, 0-0.41) of the identified group (P = 0.03). The measurement of the trapezoid area under the tunneled segment with this formula [(MB length+ intramyocardial segment) ×depth/2] had significant relation with systolic compression (r=0.304, P = 0.03) and defined the cut-off value of 250 mm2 as the value of significant difference in detecting myocardial bridging with CCA. Conclusion: Our results showed that in most of identified MBs in CCA the tunneled segment area was equal and more than 250 mm2. In addition, the degree of atherosclerotic plaque of the tunneled segments at CCA was significantly more in unidentified group.

Abstract 2800: Assessment of Computational Fluid Dynamics to Calculate Individual Coronary Wall Shear Stress In-Vivo

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Johannes Rieber ◽  
Thomas Redel ◽  
Holger Hetterich ◽  
Tobias Potzger ◽  
Konstantin Nikolaou ◽  
...  
Keyword(s):  
Fluid Dynamics ◽  
Computational Fluid Dynamics ◽  
Shear Stress ◽  
Coronary Angiography ◽  
Wall Shear Stress ◽  
Radio Frequency ◽  
Intravascular Ultrasound ◽  
Coronary Arteries ◽  
Wall Shear

Beyond classic risk parameters non physiologic or oscillating wall shear stress (WSS) has been proven to act as a local factor for initiation and progression of atherosclerosis as well as for plaque rupture. Direct measurement of WSS in-vivo is difficult and restricted to animal models. Computational fluid dynamics (CFD) is a validated tool to compute flow parameters and WSS. For this purpose an exact model of the underlying patient specific geometry of the coronary tree is a prerequisite. Using 3D-IVUS or modern multislice computed tomographic coronary angiography (CTA) with submilimeter resolution these data can be provided. The aim of this study was to 1.) demonstrate feasibility of in-vivo CFD calculation of human coronaries based on CTA and 2.) to correlate the findings with radio frequency tissue information derived by intravascular ultrasound. We prospectively included 10 patients with suspected coronary artery disease who received CTA (Dual source 64 slice CT) and invasive conventional coronary angiography. Intravascular ultrasound and ECG-triggered radio frequency analysis (VH) was attempted in all three epicardial vessels. In the CTA-dataset the coronaries were segmented and a mesh model for CFD was generated. CFD calculations were performed using a commercial available software package with laminar flow and blood as a Newtonian fluid as boundary conditions. Coronary models were stationary with rigid vessel walls, while the pulsatile inflow characteristics was derived from invasive Doppler velocity measurement. Flow pattern calculations, vessel wall shear stress and IVUS analysis were successfully performed in 24/30 and 17/30 coronary arteries. The presence of high shear stress and non turbulent flow was inversely correlated with the presence of plaque as determined by intravascular ultrasound. No correlation of any CFD parameter with the radio frequency tissue information could yet be observed. The findings of the present study demonstrate the feasibility of assessing fluid tissue interactions in human coronary arteries using CTA and its correlation to invasive findings. The possible impact of CFD parameters on risk- and treatment stratification has to be determined in a large scale prospective trial.

A Case of Stent Under-Expansion due to Calcified Plaque Treated with Shockwave Lithoplasty

Cardiology ◽  
2018 ◽  
Vol 141 (2) ◽  
pp. 75-77 ◽  
Author(s):  
Gaetano Morabito ◽  
Cesare Tripolino ◽  
Eliezer Joseph Tassone ◽  
Placido Grillo ◽  
Bindo Missiroli
Keyword(s):  
Coronary Angiography ◽  
Intravascular Ultrasound ◽  
System A ◽  
Stent Expansion ◽  
Calcified Plaque ◽  
Calcium Deposits

We report the case of a stent under-expansion due to heavily calcified plaque treated with the shockwave lithoplasty system. A 77-year-old woman underwent coronary angiography, and intravascular ultrasound revealed stent under-expansion due to calcified plaque. Shockwave lithoplasty balloon was used to disrupt calcium deposits around the stent, thereby allowing a correct stent expansion with an excellent angiographic and intravascular ultrasound result.

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