scholarly journals Circulating microRNA-21 as Stable Blood-Based Markers for Patients With ISR After PCI

2020 ◽  
Vol 23 (6) ◽  
pp. E756-E762
Author(s):  
Xiong Zhang ◽  
Xiao-Ping Xiao ◽  
Xu- Ai Ren ◽  
Wei Xue
Keyword(s):  
Coronary Intervention ◽  
Elastic Membrane ◽  
Circulating Microrna ◽  
Membrane Area ◽  
Real Time Quantitative Pcr ◽  
Stent Restenosis ◽  
Plaque Area ◽  
Minimal Lumen Area ◽  
External Elastic Membrane ◽  
Α Level

It recently has been reported that the in-stent restenosis (ISR) of expanded area after percutaneous coronary intervention (PCI) within six months can become a serious postoperative complication. A real-time quantitative PCR was used to analyze the expression of serum miR-21 in 33 ISR and 37 non-ISR patients after PCI. Expression of miR-21 was significantly higher in the ISR group compared with that in the NISR group, and a similar trend also occurred in factor- (TNF-α) level, Interleukin -6 (IL-6) level, and plaque area (PLA). However, a contrary trend occurred in the external elastic membrane area (EEM) and minimal lumen area (MLA). This study suggests that the increased expression of serum miR-21 is related to ISR after PCI, and miR-21 can be a new predictor of ISR.

Intravascular ultrasound

2021 ◽  
pp. 60-63
Author(s):  
Lorenz Räber
Keyword(s):  
Coronary Artery ◽  
Intravascular Ultrasound ◽  
Coronary Intervention ◽  
Elastic Membrane ◽  
Arterial Grafts ◽  
Anatomical Structures ◽  
Percutaneous Coronary ◽  
External Elastic Membrane ◽  
Artery Disease ◽  
Global And Local

Intravascular ultrasound represents the most established, well-validated, and widely used intracoronary imaging technology worldwide and was introduced approximately 25 years ago. Intravascular ultrasound enables the visualization of key anatomical structures of the coronary artery and saphenous or arterial grafts including the lumen, external elastic membrane, and adventitia and thereby provides the basis for the assessment of the degree of coronary artery stenosis, extent of atherosclerosis burden (i.e. global and local disease burden), and plaque composition. All this represents key information to plan and perform percutaneous coronary intervention procedures in native coronary artery disease or graft lesions and to estimate the risk for future cardiovascular events.

Abstract 12492: Multimodality Intravascular Imaging Assessment of Plaque Erosion vs Plaque Rupture in Patients With Acute Coronary Syndrome

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Sang-Wook Kim ◽  
Hoyoun Won ◽  
Gary S Mintz ◽  
Young Joon Hong ◽  
Sung Yun Lee ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Plaque Rupture ◽  
Elastic Membrane ◽  
Lesion Length ◽  
Intravascular Imaging ◽  
Lumen Area ◽  
Membrane Area ◽  
Coronary Syndrome ◽  
Plaque Erosion ◽  
Minimal Lumen Area

We used optical coherent tomography (OCT) and virtual histology intravascular ultrasound (VH-IVUS) to assess culprit lesions in 146 Korean pts with acute coronary syndrome (ACS). Methods: Culprit lesion plaque rupture (PR) or plaque erosion (PE) was diagnosed with OCT; and IVUS was used to determine arterial remodeling. PE (n=56) was the presence of intracoronary thrombus attached to the luminal surface with no detectable signs of fibrous cap rupture that was seen in 90 ACS pts with PR. Positive remodeling was a remodeling index (lesion/reference EEM [external elastic membrane] area) >1.05. Results: Pt age was 60±12 yrs in PR and 62±11 yrs in PE; 19% of PR vs 18% of PE were females. Overall, 25% (14/56) of PE had non-ST elevation myocardial infarction (NSTEMI) and 34% (19/56) had STEMI; conversely, 14.4% (13/90) of PR had NSTEMI and 71% (64/90) had STEMI (p<0.0001). Vessel size, minimal lumen area, and lumen area at the PR or PE site were similar; however, lesion length was longer in PR. Plaque area was smaller with negative remodeling in PE while PR showed positive remodeling with a larger necrotic core area by VH-IVUS (Table). By OCT, PE were fibrotic in 50% (28/56), fibrocalcific in 16% (9/56), and lipidic in 32.1% (18/56, all but one of which was a thick cap fibroatheroma). Conclusion: Multimodality intravascular imaging with OCT and VH-IVUS showed fundamentally different pathoanatomic substrates underlying plaque rupture and erosion in Asian pts.

Abstract 15562: Impact of Off-time Presentation on the Vulnerability of the Culprit Lesions in ST-elevation Acute Myocardial Infarction

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Young Kim ◽  
Sang Wook Kim ◽  
Wang Soo Lee ◽  
Hoyoun Won ◽  
Seong Hyeop Hyeon ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Working Hours ◽  
Necrotic Core ◽  
Plaque Burden ◽  
Elastic Membrane ◽  
Membrane Area ◽  
Minimal Lumen Area ◽  
Remodeling Index ◽  
St Elevation ◽  
Working Hour

Background: ST-elevation myocardial infarction (STEMI) that occurs during the off hours shows worse clinical status compared to the patients presenting during working hours. Method: We used Virtual Histology Intravascular Ultrasound (VH-IVUS) to assess the complexity of culprit lesion in 193 patients with STEMI. The patients were divided into two groups that presented to the hospital during the working hours (from 8:30 am to 6:00 pm) and the off hours (from 6:00 pm to 8:30 am of the next day). VH-TCFA (thin-capped fibroatheroma) was defined as necrotic core (NC) >10% of plaque area with a plaque burden of >40% and NC in contact with the lumen for ≥3 image slices. Positive remodeling was a remodeling index (lesion/reference EEM [external elastic membrane] area) >1.05. Result: 91(46.0%) pts were visited during working hours, and 102(54.0%) pts during the off hours. Pt age was 60±13 yr in working hour STEMI and off hour STEMI was 61±10 yr. The lesion length, vessel size and minimal lumen area (MLA) were similar. The average and maximum necrotic core area of the off hours STEMI were larger than the working hours STEMI(p=0.025 and p=0.005 respectively). The remodeling index at maximum necrotic core site was also higher in the off hours STEMI than the working hours group respectively (p=0.042). Positive remodeling was 42.9%(39/91) in working hour STEMI and 59.8%(61/102) in off hour STEMI (p=0.028). However, the frequency of TCFA was similar in both group(25.7% vs 26.6%, p=0.123). Conclusion: The culprit lesions of Off-hour STEMI may more vulnerable compared to STEMI occuring during the working hours.

Provisional and Complex Techniques for Bifurcation Treatment – Trading Apposition for Scaffolding?

2012 ◽  
Vol 7 (1) ◽  
pp. 44
Author(s):  
Nicolas Foin ◽  
Eduardo Alegria-Barrero ◽  
Ryo Torii ◽  
Pak H Chan ◽  
Ajay K Jain ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
New Technology ◽  
Coronary Intervention ◽  
Target Lesion ◽  
Side Branch ◽  
Simultaneous Increase ◽  
Stent Restenosis ◽  
Percutaneous Coronary ◽  
Stent Coverage ◽  
Bifurcation Lesions

Provisional T-stenting with stenting of the main branch and optional side branch (SB) stenting in the case of significant SB occlusion with thrombolysis in myocardial infarction (TIMI) flow <3 is the strategy chosen nowadays by most interventionalists for treating simple bifurcation lesions. Percutaneous coronary intervention (PCI) of complex true bifurcation lesions remains, however, the subject of debate: treatment of complex bifurcation lesions requires more time than treatment of simple bifurcations and can lead to significantly higher rates of restenosis, target lesion revascularisation and myocardial infarction. Current bifurcation techniques often fail to ensure continuous stent coverage of the SB ostium and of the two bifurcation branches without a simultaneous increase in the rate of malapposed struts. Stent struts left unapposed in the lumen disturb blood flow and are increasingly recognised as increasing the risk of stent thrombosis and focal in-stent restenosis, limiting the success of stent procedures in these lesions. New technology and dedicated designs may, in the near future, overcome such limitations of conventional two-stent bifurcation strategies.

scholarly journals Structural Design of Vascular Stents: A Review

Micromachines ◽  
2021 ◽  
Vol 12 (7) ◽  
pp. 770
Author(s):  
Chen Pan ◽  
Yafeng Han ◽  
Jiping Lu
Keyword(s):  
Cardiovascular Diseases ◽  
Hot Spot ◽  
Coronary Intervention ◽  
Patient Specific ◽  
Vascular Stent ◽  
Vascular Stents ◽  
Stent Restenosis ◽  
Percutaneous Coronary ◽  
Representative Unit Cell ◽  
Volume Unit

Percutaneous Coronary Intervention (PCI) is currently the most conventional and effective method for clinically treating cardiovascular diseases such as atherosclerosis. Stent implantation, as one of the ways of PCI in the treatment of coronary artery diseases, has become a hot spot in scientific research with more and more patients suffering from cardiovascular diseases. However, vascular stent implanted into vessels of patients often causes complications such as In-Stent Restenosis (ISR). The vascular stent is one of the sophisticated medical devices, a reasonable structure of stent can effectively reduce the complications. In this paper, we introduce the evolution, performance evaluation standards, delivery and deployment, and manufacturing methods of vascular stents. Based on a large number of literature pieces, this paper focuses on designing structures of vascular stents in terms of “bridge (or link)” type, representative volume unit (RVE)/representative unit cell (RUC), and patient-specific stent. Finally, this paper gives an outlook on the future development of designing vascular stents.

Characteristics and Outcomes of Patients Undergoing Coronary Intervention for In-Stent Restenosis

2021 ◽  
Vol 28 ◽  
pp. S23-S24
Author(s):  
Chava Chezar-Azerrad ◽  
Charan Yerasi ◽  
Brian C. Case ◽  
Brian J. Forrestal ◽  
Giorgio A. Medranda ◽  
...  
Keyword(s):  
Coronary Intervention ◽  
Stent Restenosis ◽  
In Stent Restenosis

scholarly journals Inflammatory cells in perivascular adipose tissue and the integrity of the tunica media in atherosclerotic coronary arteries

2019 ◽  
Author(s):  
Ruda Zorc-Pleskovič ◽  
Marjeta Zorc ◽  
Dušan Šuput ◽  
Aleksandra Milutinović
Keyword(s):  
Adipose Tissue ◽  
Coronary Arteries ◽  
Obstructive Coronary Artery Disease ◽  
Inflammatory Cells ◽  
Elastic Membrane ◽  
Inflammatory Infiltration ◽  
Perivascular Adipose Tissue ◽  
Tunica Media ◽  
External Elastic Membrane ◽  
The Media

Obstructive coronary artery disease (CAD) is characterized by inflammation within the atherosclerotic coronary arteries. Infiltration of inflammatory cells into muscular media can lead to remodeling and weakening of the arterial wall. We examined the relationship between inflammatory infiltration in perivascular adipose tissue (PVAT), state of the external elastic membrane, and the intensity of inflammatory infiltration in the tunica media of coronary arteries obtained by endarterectomy from symptomatic patients with diffuse CAD. We analyzed endarterectomy sequesters from 22 coronary arteries that contained the intima, media, a part of the adventitia, and PVAT in at least one part of the sequester. The coronary arteries were divided into two groups according to the presence or absence of inflammatory infiltration in PVAT. Staining with hematoxylin-eosin and by the Movat's method showed atherosclerotic changes in the intima and media. Immunohistochemistry (anti-leukocyte common antigen [LCA] antibody) was used for the detection of leukocytes. We found a significant positive correlation between inflammatory infiltration in PVAT and preservation of the external elastic membrane of coronary arteries. Furthermore, we found a significant negative correlation between inflammatory infiltration in PVAT and the intensity of inflammatory infiltration in the media. It seems that the integrity of the external elastic membrane and the proinflammatory properties of PVAT restrain inflammatory cells within PVAT. Both effects may prevent the migration of inflammatory cells into the media and delay the development of CAD.

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