Study on the characteristics of coronary calcification by Intravascular Ultrasound (IVUS)

2022 ◽  
Vol 35 ◽  
pp. 188-195
Author(s):  
Hoang Van
Keyword(s):  
Coronary Artery ◽  
Coronary Angiography ◽  
Intravascular Ultrasound ◽  
Coronary Calcification ◽  
Coronary Artery Lesions ◽  
Coronary Lesions ◽  
Artery Disease ◽  
Calcification Detection ◽  
Anatomical Information ◽  
Calcified Coronary Lesions

Background: Percutaneous coronary angiography is considered the "gold standard" for the diagnosis of coronary artery disease and provides the necessary anatomical information to provide appropriate treatment. The limitation of coronary angiography is the accurate assessment of calcified coronary lesions. Intravascular ultrasonography has many advantages in the assessment of calcified coronary lesions. Methods: The descriptive clinical study. Evaluation of calcified coronary artery lesions by intravascular ultrasound Results: From January 2019 to December 2019, at the Hanoi Heart Institute, 64 patients had 64 coronary artery lesions surveyed by intravascular ultrasound. There were 42 (65,6%) calcified lesions assessed by IVUS and 25 (39,1%) calcified lesions were detected by coronary angiography. In addition, the location of calcified were revealed more in the LAD compared to other: LAD 60%, LCx 24%, RCA 12% and LM 4%. Conclusion: IVUS calcification detection rate is higher than coronary angiography. The most common site of calcification in the LAD.

Plasma Lipoprotein(a) Values and Severity of Coronary Artery Disease in a Large Population of Patients Undergoing Coronary Angiography

1992 ◽  
Vol 38 (11) ◽  
pp. 2261-2266 ◽  
Author(s):  
C Labeur ◽  
D De Bacquer ◽  
G De Backer ◽  
J Vincke ◽  
L Muyldermans ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Angiography ◽  
Coronary Stenosis ◽  
Large Population ◽  
Univariate Analysis ◽  
Confounding Factors ◽  
Coronary Artery Lesions ◽  
Male And Female ◽  
Lipoprotein A ◽  
Artery Disease

Abstract To determine possible associations between lipoprotein(a) [Lp(a)] and the severity of coronary artery lesions, we measured lipid, apolipoprotein, and Lp(a) in a large population of Belgian patients (n = 1054) undergoing coronary angiography. In both women and men, univariate analysis demonstrated significant differences in the Lp(a) concentrations according to the severity of the coronary stenosis. However, after adjustment for possible confounding factors, many of these differences were attenuated, indicating that other variables that differentiate patients from control subjects also influence Lp(a) distribution. Differences in lipid, apolipoprotein, and Lp(a) concentrations between male and female patients are discussed.

scholarly journals Unique angiographic findings in a patient with myocardial ischemia and immunoglobulin G4-related disease

2017 ◽  
Vol 5 ◽  
pp. 2050313X1772801
Author(s):  
Yusuke Kanzaki ◽  
Takashi Miura ◽  
Naoto Hashizume ◽  
Tatsuya Saigusa ◽  
Soichiro Ebisawa ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Intravascular Ultrasound ◽  
Plasma Cells ◽  
Immunoglobulin G4 ◽  
Related Disease ◽  
Multiple Organs ◽  
History Of ◽  
Artery Disease

Immunoglobulin G4-related disease characteristically involves multiple organs including the heart and coronary arteries. Immunoglobulin G4-related coronary artery disease is thought to be due to periarteritis and histopathologically is characterized by marked thickening of the adventitia and periarterial fat with infiltration of immunoglobulin G4-positive plasma cells. Although comprehensive diagnostic criteria require a biopsy for a definite or probable diagnosis of immunoglobulin G4-related disease, obtaining a coronary artery biopsy is difficult and risky. However, imaging findings including coronary angiography and intravascular ultrasound might be useful tools to establish a diagnosis of immunoglobulin G4-related coronary artery disease. We report a case of a 63-year-old man with a history of immunoglobulin G4-related disease who presented with exertional chest pain. We found unique angiographic and intravascular ultrasound features of immunoglobulin G4-related coronary artery disease that distinguished it from those of arteriosclerotic coronary artery disease and suggest that coronary angiography and intravascular ultrasound might be useful tools in the diagnosis of immunoglobulin G4-related coronary artery disease.

scholarly journals Trans-coronary Pacing via Rota Wire Prevents Bradycardia During Rotational Atherectomy: A Case Report

2022 ◽  
Author(s):  
Hirofumi Kusumoto ◽  
Kasumi Ishibuchi ◽  
Katsuyuki Hasegawa ◽  
Satoru Otsuji
Keyword(s):  
Coronary Artery ◽  
Coronary Angiography ◽  
Coronary Stenosis ◽  
Calcified Lesion ◽  
Temporary Pacemaker ◽  
Coronary Lesions ◽  
Pacemaker Insertion ◽  
Calcified Coronary Lesions ◽  
Significant Coronary Stenosis ◽  
Severe Calcification

Abstract Back ground Rotational atherectomy (RA) is used for plaque modification in patients with heavily calcified coronary lesions. RA can induce significant bradycardia or atrioventricular block requiring for temporary pacemaker insertion. In this report, we present a case of trans-coronary pacing via a Rota wire to prevent bradycardia during RA in the proximal right coronary artery (RCA). Case summary A 72-year-old woman with a one month history of worsening effort angina was admitted to our hospital. Computed tomography coronary angiography disclosed significant coronary stenosis with severe calcification in proximal RCA. Coronary angiography revealed significant coronary stenosis with severe calcification in the proximal RCA. Subsequently, percutaneous coronary artery intervention was performed under the guidance of intravascular ultrasound(IVUS). The pull-back IVUS showed a circumferential calcified lesion in the proximal RCA, that was treated using RA, which induced significant bradycardia requiring temporary pacemaker insertion. Immediately, trans-coronary pacing was provided via a Rota wire placed in the far distal RCA; this was used for back-up pacing during RA. RA was completed by safely modifying the calcified lesion. After successful debulking of the calcified lesion, we dilated with a balloon, and a drug-eluting stent was implanted at the proximal RCA. Final IVUS and angiography showed good stent apposition and expansion. we did not observe any serious intraprocedural complications. Discussion RA is used for plaque modification in patients with heavily calcified coronary lesions. RA can induce significant bradycardia or atrioventricular block requiring for temporary pacemaker insertion via the transvenous route. This method could be an effective method to prevent bradycardia during RA.

Abstract 1985: Increased Plaque Mass, but not Relative Plaque Composition, Distinguishes Culprit Coronary Artery Lesions in Patients with Acute Coronary Syndrome: A Lesion Analysis by Intravascular Ultrasound Histology

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Andrew Frutkin ◽  
Sameer K Mehta ◽  
Justin R McCrary ◽  
John House ◽  
Steven P Marso
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Intravascular Ultrasound ◽  
Atherosclerotic Plaque ◽  
Obstructive Coronary Artery Disease ◽  
Plaque Burden ◽  
Lumen Area ◽  
Coronary Artery Lesions ◽  
Plaque Composition ◽  
Artery Disease

INTRODUCTION Intravascular ultrasound Virtual Histology (IVUS-VH) uses radiofrequency analysis to measure coronary artery plaque geometry and classify plaque components into one of four categories: fibrous, fibrofatty, necrotic or calcified. We hypothesized that patients with acute coronary artery syndrome (ACS) would have atherosclerotic plaque geometry and composition that differs from patients with stable, obstructive coronary artery disease. METHODS In a crossectional study we used IVUS-VH to image 38 culprit lesions of 28 ACS patients and 104 lesions of 71 non-ACS patients prior to intervention. In both ACS and non-ACS patients, culprit lesions were defined as the site of percutaneous coronary intervention with at least 3 contiguous frames of > 40% percent plaque burden (100 × [external elastic membrane (EEM ) area − lumen area]/EEM area ) and a neointimal thickness > 600 um subtending an arc of > 10% vessel circumference. Plaque geometry and composition were measured with IVUS-VH software (pcVH v.2.2, Volcano Corp). A remodeling index was calculated as the ratio of the EEM area at the frame of the minimal lumen area to the EEM area of a reference frame (within 10 mm of MLA). RESULTS Lesions of ACS patients were longer and had greater plaque volume than non-ACS patients (Table ). The proportions of IVUS-derived plaque components were similar in both ACS and non-ACS culprit lesions (Table ). CONCLUSION Culprit coronary artery lesions in ACS patients have greater plaque mass than in non-ACS patients, but relative plaque composition is similar between these patient populations. Measurements of atherosclerotic plaque mass may discriminate better than plaque composition as to which patients with severe, obstructive coronary artery disease are at greatest risk of coronary artery thrombosis. Longitudinal studies using IVUS-VH will best resolve which IVUS-VH measurements of plaque geometry and composition have greatest predictive value.

When Calcium Gets Tough, the Tough Cardiologist Starts to Play …

Cardiology ◽  
2018 ◽  
Vol 141 (3) ◽  
pp. 167-171 ◽  
Author(s):  
Eliezer Joseph Tassone ◽  
Cesare Tripolino ◽  
Gaetano Morabito ◽  
Placido Grillo ◽  
Bindo Missiroli
Keyword(s):  
Coronary Angiography ◽  
Coronary Calcification ◽  
Rotational Atherectomy ◽  
Sound Waves ◽  
Diagonal Branch ◽  
Coronary Syndrome ◽  
First Case ◽  
Coronary Lesions ◽  
Angioplasty And Stenting ◽  
Calcified Coronary Lesions

Coronary calcification is a hard challenge for the interventional cardiologist, as it is associated with incomplete stent expansion and frequently stent failure. In recent years, innovative techniques, such as rotational atherectomy, have been developed to treat coronary calcification. However, these are burdened with an increased procedural risk. We report the case of a 60-year-old Caucasian man treated 1 month before at another center with primary coronary angioplasty and stenting of the ramus intermedius for coronary syndrome. Coronary angiography showed a critical stenosis of the left main coronary artery as well as critical calcified stenosis of the left anterior descending artery and the diagonal branch. Coronary calcification was treated with rotational atherectomy that preceded the angioplasty and stenting. Because of persistence of the symptomatology, coronary angiography was repeated 1 month later and showed a critical calcified restenosis of the ramus intermedius at the site of the previous stenting. Considering the high risk of traditional atherectomy, we performed lithotripsy-enhanced disruption of calcium beyond the stents with the Shockwave Coronary Lithoplasty System. The Shockwave Coronary Lithoplasty System has been introduced recently in order to treat calcified coronary lesions with greater safety. The procedure allows most calcified coronary lesions to be treated with simplicity and safety. This system employs sound waves, similar to those used for treating kidney stones, to crush the calcified lesions. We present the first case described to date in whom this technique was successfully used to treat calcified restenosis in a previous stent.

scholarly journals Angiographic Comparison of Coronary Artery Disease between Diabetic Men and Women

2013 ◽  
Vol 6 (1) ◽  
pp. 3-9
Author(s):  
Md. Sk. Mamun ◽  
AAS Majumder ◽  
M Ullah ◽  
S Alam
Keyword(s):  
Cardiovascular Disease ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Diabetic Patients ◽  
Study Group ◽  
Coronary Artery Lesions ◽  
Group I ◽  
Group Ii ◽  
Artery Disease

Background: Cardiovascular diseases are the leading cause of death and morbidity in diabetic patients and this group is two to four times as likely to develop cardiovascular disease than the nondiabetic group, women being specially involved in this situation. In women , diabetes appear to be a stronger risk factor for the development of coronary heart disease than in men regardless of age ,menopausal status and whether or not the patient is insulin or non-insulin dependent. Objective of this study was to compare the angiographic extent of coronary artery disease between diabetic men and diabetic women. Method: This observational study was undertaken on 100 diabetic patients ( 50 women and 50 men) admitted inNational Institute of Cardiovascular disease (NICVD) during the period of July, 2006 to April ,2007.Diabetic women with coronary artery disease constitute the study group-I and diabetic men with coronary artery disease matched for age (±5 years) and risk factors , the study group-II . Coronary angiography was done in all patients & findings were analyzed. Segmental distribution method for coronary artery lesions was used to describe the distribution of atherosclerotis in coronary artery. Results: The mean age of group I was 51.02 ±8.93 years and that of the group II was 50.99± 9.83 years. In this study it was found that Diabetic women with coronary artery disease (CAD) had a higher coronary artery score, CAS (11.02±5.034) as compared to the diabetic men with CAD ( 8.04±4.866) (p<0.001). Diabetic women had also higher number of diseased vessels ( 78.67% vs 67.34%; p<0.01) and higher number of vessel score 3 ( 58% vs 34%; p<0.001). As compared to the diabetic men, diabetic women had a higher total number of coronary artery lesions (183 vs 136; p<0.001), a higher number of lesions per patient (3.66/ patients vs 2.72/patients; p<0.001) and a higher number of diffuse vessels (13.56% vs 8.91%;p<0.05). Conclusion: Diabetic women with coronary artery disease have more severe disease on coronary angiography as compared to diabetic men with coronary artery disease. The diffuse coronary artery involvement was also significantly higher in diabetic women than men. Cardiovascular Journal Volume 6, No. 1, 2013, Page 3-9 DOI: http://dx.doi.org/10.3329/cardio.v6i1.16108

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