A congenital, cerebriform, yellow plaque on the ear

Abstract Background Many vulnerable plaques would progress without clinical events and might result in healed plaques (HPs). Histopathological or intracoronary image assessment of HPs has been reported. However, the morphological characteristics of HPs remain unclear yet. Purpose We sought to assess the healed vulnerable plaque components in patients with coronary artery lesions using optical coherence tomography (OCT) and coronary angioscopy (CAS). Methods We enrolled 47 patients with 50 native coronary artery lesions with angiographical severe stenosis (>90% diameter-stenosis) and without severe calcification (36 lesions with stable angina pectoris (SAP) and 14 acute coronary syndrome (ACS)) undergoing pre-intervention OCT and CAS. HPs was defined as layered phenotype on OCT. Lesion morphologies and plaque characteristics in lesions with HPs were assessed using OCT and CAS images. Results HPs were observed in 27 lesions (54.0%) and their prevalence were similar among each clinical status (SAP 52.8%, ACS 57.1%, p=1.00). Lesions with HPs had higher prevalence of OCT-macrophage (88.0% vs. 52.0%, p=0.01), CAS-red thrombus (88.8% vs. 52.2%, p=0.004) and CAS-low grade-yellow plaque (grade 1) (55.6% vs. 21.7%, p=0.02) than those without. SAP lesions with HPs had higher prevalence of CAS-yellow plaque (35.3% vs. 5.9%, p=0.09) and OCT-thin-cap fibroatheroma (42.1% vs. 5.9%, p=0.04) than SAP without HPs. ACS lesions with HPs had less CAS-red thrombus (0.0% vs. 50.0%, p=0.03) and OCT-plaque rupture (12.5% vs. 66.7%, p=0.04) than ACS without HPs. Multivariate logistic regression analysis revealed that OCT-macrophages (odds ratio (OR): 6.65, 95%-confidence intervals: 1.07–41.5, p=0.043), CAS-red thrombus (OR 8.77, 95% CI 1.33–57.8, p=0.02), and low grade-yellow plaque (OR 13.05, 95% CI 1.97–86.5, p=0.008) were independently related with the existence of HPs lesions. Combination of these 3 factors showed a high predictive value of OCT-HPs lesions (90.9%). Conclusions HPs lesions showed the lower lesion vulnerability than common ACS lesions but had more intraplaque inflammatory condition compared with common SAP lesions. Combined CAS and OCT examination might be useful to clarify the plaque components of HPs lesions in vivo, leading to help us understand the clinical significance of HPs. Funding Acknowledgement Type of funding source: None

Download Full-text

P3386Angioscopic comparison between polymer-free biolimus A9-coated stent and durable polymer drug-eluting stent 10 months after the implantation

European Heart Journal ◽

10.1093/eurheartj/ehz745.0262 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

T Tsujimura ◽

T Ishihara ◽

O Iida ◽

M Asai ◽

M Masuda ◽

...

Keyword(s):

De Novo ◽

Drug Eluting Stent ◽

Light Yellow ◽

Yellow Color ◽

Yellow Plaque ◽

Durable Polymer ◽

Biolimus A9 ◽

Drug Eluting ◽

Neointimal Coverage ◽

Grade 3

Abstract Background Polymer-free biolimus A9-coated stent (DCS) has currently emerged as expected better arterial healing compared to durable polymer drug-eluting stent (DP-DES). However, superiority of DCS on arterial healing over DP-DES has not been well elucidated using intracoronary images. Methods This study examined 288 stents in 224 patients with de novo coronary artery lesions. We angioscopically compared 55 DCS from 35 patients with 233 DP-DES from 189 patients 10±2 months after the implantation. We assessed thrombus adhesion, which is a marker of incomplete re-endothelialization. Dominant neointimal coverage (NIC) grade, heterogeneity of NIC and maximum yellow color of plaque underneath the stent were also evaluated. Neointimal coverage was graded as follows: grade 0, stent struts exposed; grade 1, struts bulged into the lumen, although covered; grade 2, struts embedded by the neointima, but translucent; grade 3, struts fully embedded and invisible. NIC was judged as heterogeneous when differences in the NIC grade became apparent. Yellow plaque was graded as follows: grade 0, white; grade 1, light yellow; grade 2, yellow; grade 3, intensive yellow. Results Thrombus adhesion was similar between DCS and DP-DES (29% versus 23%, P=0.32). Dominant NIC was greater in DCS than in BP-DES (P<0.001), while NIC was more heterogeneous in DCS than in BP-DES (P=0.001, Figure). Maximum yellow color of stented segment was similar between DCS and DP-DES (P=0.09). Conclusion DCS provided similar thrombus adhesion to DP-DES, which suggested similar re-endothelialization 10 months after implantation. However, DCS showed thick and heterogeneous NIC compared to DP-DES. The specific feature of polymer-free and Biolimus A9 would cause the difference, and further investigation is necessary to evaluate the longer-term safety and efficacy. Acknowledgement/Funding None

Download Full-text

TCT-828 Quantitative Validation of the Coronary-Angioscopic Yellow Plaque by Lipid Core Burden Index Assessed by Intra-Coronary Near-Infrared Spectroscopy

Journal of the American College of Cardiology ◽

10.1016/j.jacc.2019.08.976 ◽

2019 ◽

Vol 74 (13) ◽

pp. B811

Author(s):

Takashi Omatsu ◽

Tomoaki Kobayashi ◽

Yohei Sotomi ◽

Yuma Hamanaka ◽

Yasunori Ueda ◽

...

Keyword(s):

Infrared Spectroscopy ◽

Near Infrared Spectroscopy ◽

Near Infrared ◽

Lipid Core ◽

Yellow Plaque ◽

Quantitative Validation

Download Full-text

Angioscopic observation of an atherosclerotic coronary aneurysm without yellow plaque

BMJ Case Reports ◽

10.1136/bcr-2017-221306 ◽

2017 ◽

pp. bcr-2017-221306

Author(s):

Yasuyuki Toyama ◽

Sei Komatsu ◽

Mitsuhiko Takewa ◽

Kazuhisa Kodama

Keyword(s):

Coronary Aneurysm ◽

Yellow Plaque

Download Full-text

Different vascular healing process between bioabsorbable polymer-coated everolimus-eluting stents versus bioresorbable vascular scaffolds via optical coherence tomography and coronary angioscopy (the ENHANCE study: ENdothelial Healing Assessment with Novel Coronary tEchnology)

Heart and Vessels ◽

10.1007/s00380-019-01516-9 ◽

2019 ◽

Vol 35 (4) ◽

pp. 463-473 ◽

Cited By ~ 1

Author(s):

Wan Azman Wan Ahmad ◽

Takaharu Nakayoshi ◽

Ahmad Syadi Mahmood Zuhdi ◽

Muhammad Dzafir Ismail ◽

Imran Zainal Abidin ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Healing Process ◽

Coronary Vessels ◽

Optical Coherence ◽

Bioabsorbable Polymer ◽

Neointimal Thickness ◽

Yellow Plaque ◽

Coronary Angioscopy ◽

Vascular Scaffolds ◽

Bioresorbable Vascular Scaffolds

Abstract Recent clinical trials have raised concerns about the safety and efficacy of ABSORB™ bioresorbable vascular scaffolds (BVS). The difference in the vascular healing process between SYNERGY™ bioabsorbable polymer-coated everolimus-eluting stents (BP-EES) and BVS remains unclear. The aim of the ENHANCE study was to compare vascular healing on BP-EES versus BVS by optical coherence tomography (OCT) and coronary angioscopy (CAS) at 4- and 12-month follow-ups. This is a prospective, non-randomized, single center clinical trial. Thirteen eligible patients with multivessel disease were enrolled. BP-EES and BVS were simultaneously implanted in the same patients, but in different coronary vessels. Imaging follow-up with both OCT and CAS was completed in 11 patients at 12 months. Neointimal coverage rates were similar between the two groups based on OCT measurements. The neointimal thickness of BP-EES was significantly thicker at the 12th month than at the 4th month, whereas the neointimal thickness of BVS did not change between the measurements taken at the 4th and 12th month. Existence of intra-stent thrombus was significantly higher in the BVS group, compared to the BP-EES group. On the other hand, CAS revealed that red-thrombi and yellow-plaque were more frequently observed in BVS at 4 months and up to 12-month follow-ups than in BP-EES. These findings suggested that the evidence of instability remained up to 12 months in the vascular healing with BVS, compared to that with BP-EES. Vascular healing of the stented wall was recognized at the very early phase after BP-EES implantation. However, vascular healing with BVS was still incomplete after 12 months.

Download Full-text

Detection of yellow plaque by near-infrared spectroscopy – Comparison with coronary angioscopy in a case of no-flow phenomenon during coronary intervention

Journal of Cardiology Cases ◽

10.1016/j.jccase.2014.01.010 ◽

2014 ◽

Vol 9 (5) ◽

pp. 192-195

Author(s):

Yasunori Ueda ◽

Koshi Matsuo ◽

Yuji Nishimoto ◽

Ryuta Sugihara ◽

Mayu Nishio ◽

...

Keyword(s):

Infrared Spectroscopy ◽

Near Infrared Spectroscopy ◽

Near Infrared ◽

Coronary Intervention ◽

Flow Phenomenon ◽

Yellow Plaque ◽

Coronary Angioscopy

Download Full-text

A higher colour grade yellow plaque was detected at one year after implantation of an everolimus-eluting stent than after a zotarolimus-eluting stent

Heart Asia ◽

10.1136/heartasia-2013-010378 ◽

2013 ◽

Vol 5 (1) ◽

pp. 192-196 ◽

Cited By ~ 3

Author(s):

Koshi Matsuo ◽

Yasunori Ueda ◽

Mayu Nishio ◽

Akio Hirata ◽

Mitsutoshi Asai ◽

...

Keyword(s):

Yellow Plaque ◽

One Year

Download Full-text

Abstract 3330: Effect of Achieved Low-density Lipoprotein Cholesterol Level by Atorvastatin on Stabilization of Coronary Plaques - Results from TWINS study

Circulation ◽

10.1161/circ.116.suppl_16.ii_750-b ◽

2007 ◽

Vol 116 (suppl_16) ◽

Author(s):

Katsuki Okada ◽

Yasunori Ueda ◽

Satoshi Saito ◽

Atsushi Hirayama ◽

Kazuhisa Kodama

Keyword(s):

Cholesterol Level ◽

Ldl Cholesterol ◽

Low Density Lipoprotein ◽

Density Lipoprotein ◽

Coronary Plaque ◽

Lipid Lowering ◽

Lipid Lowering Therapy ◽

Yellow Plaque ◽

The Mean

Background We have previously reported the stabilization and regression of coronary plaque by atorvastatin using both angioscopy and IVUS. However, it has not been clarified if plaque stabilization is achieved through the reduction of cholesterol level or the direct effect of statin. Then, we analyzed the effect of achieved low-density lipoprotein (LDL) cholesterol level on the stabilization of coronary plaque. Methods Twenty-nine patients with hypercholesterolemia and coronary heart disease were studied. They received lipid-lowering therapy with atorvastatin (10 –20 mg/day) for 80 weeks and were divided into 2 groups by the achieved LDL cholesterol level at 80-week follow up (low LDL group: LDL cholesterol < median value, and high LDL group: LDL cholesterol ≥ median value). Angioscopic examination was performed before and after 80 weeks treatment with atorvastatin. Angioscopic findings of coronary yellow plaque characteristics were divided into six grades (grade 0 to 5) to evaluate vulnerability of plaques; and the mean grade of each patient was evaluated. Results In all 29 patients, LDL cholesterol level was reduced (146.2 to 87.9 mg/dl; p<0.001) and the mean yellow plaque grade was decreased (1.4 to 1.2; p=0.002) at 80-week follow up. LDL cholesterol level was reduced both in low LDL group (140.3 to 75.9 mg/dl; p<0.001) and in high LDL group (151.7 to 99.1 mg/dl; p<0.001). Angioscopic examination showed significant improvement of the grade in low LDL group (1.4 to 1.1; p=0.012) at 80-week follow up, but no significant difference in high LDL group (1.4 to 1.3; p=0.11). Conclusions Lipid-lowering therapy with atorvastatin stabilized coronary plaques, and this effect was larger in the patients LDL cholesterol was reduced more.

Download Full-text