Added Value of Invasive Coronary Imaging for Plaque Rupture and Erosion
|
|
- Rebecca Gibson
- 5 years ago
- Views:
Transcription
1 Assessment of Coronary Plaque Rupture and Erosion Added Value of Invasive Coronary Imaging for Plaque Rupture and Erosion Yukio Ozaki, MD, PhD, FACC, FESC Cardiology Dept., Fujita Health Univ. Toyoake, Japan
2 Declaration of Conflict of Interest Nothing to Disclose
3 ACS and Stable Angina ACS Stable Angina Feyter PJ, Ozaki Y, et al. Circulation 1995;92:
4 Stable and Unstable Plaque (ACS) - The stable plaque does not kill patients (i.e. just makes their lives difficult). - The unstable plaque cause thrombosis and partial or total vessel occlusion leading to major clinical events. Patrick W. Serruys; Gruentzig Lecture, ESC 2001
5 Vulnerable Lesion Characteristics Assessed by QCA, IVUS, Angioscopy ACS (n=44) SAP (n=23) p Thrombus, n (%) 30 (68%) 4 (17%) <.001 Occlusive 2 (5%) 0 (0%) Protruding 8 (18%) 1 (4%) Mural 20 (45%) 3 (13%) Lesion Surface, n (%) Ulcerated or Rough 31 (70%) 9 (39%) <.05 Smooth 13 (30%) 14(61%) <.05 Feyter PJ, Ozaki Y, et al. Circulation 1995;92:
6 Invasive & Noninvasive Imaging Modalities ACS SAP
7 High-risk and Vulnerable Plaque 1. A plaque prone to rupture (60-75%) Thin Cap Fibrous Atheroma (TCFA) 2. A plaque prone to erosion (20-40%) 3. A plaque with a calcified nodule (2-7%) Vulnerable Plaque Rupture Erosion Thrombosis Santorini Island Schaar JA, et al. Terminology for high-risk and vulnerable coronary artery plaques. European heart journal, 2004, 25:
8 Vulnerable plaque 1. A plaque prone to rupture (60-75%) TCFA (thin-cap fibroatheroma): A lipid-rich, atheromatous core A thin fibrous cap, with macrophage and lymphocyte infiltration decreased smooth muscle cell content Expansive remodeling Schaar JA, et al. European Heart Journal 2004; 25:
9 Vulnerable plaque 2. A plaque prone to erosion (20-40%) Eroded plaque with thrombosis Thick fibrous cap Rich in proteoglycan and smooth muscle Schaar JA, et al. European Heart Journal 2004;25:
10 Vulnerable plaque 3. A plaque with a calcified nodule (2-7%) Schaar JA, et al. European Heart Journal 2004;25:
11 Ruptured Plaque (RFC-ACS) A1 A2 B C 1mm 1mm 1mm D E F1 F2 Ozaki Y, et al Eur Heart J 2011;32:
12 Ozaki Y, et al Eur Heart J 2011;32: Plaque Erosion (IFC-ACS) A B C 1mm 1mm D E F
13 Ozaki Y, et al Eur Heart J 2011;32: A Stable Plaque B C 1mm 1mm D E F
14 Coronary tissue characterization IB-IVUS Fibrosis Dense Fibrosis Form cell Fibrosis Fibrosis Extra-cellarer lipid Fibrosis VH-IVUS Vulnerable plaque Fibro-fatty Lipid pool + attenuation Necrotic core Calcification Dense calcification
15 ClearView TM VISIWAVE TM lipid pool fibrosis dense fibrosis calcification 44.88(%) 49.26(%) 5.07(%) 0.79(%) lipid pool fibrosis dense fibrosis calcification 47.47(%) 47.95(%) 4.06(%) 0.52(%) EEM Area: (mm 2 ) EEM Area: (mm 2 ) Lumen Area: 4.31 (mm 2 ) Lumen Area: 4.27 (mm 2 ) Plaque Area: (mm 2 ) Plaque Area:11.77 (mm 2 ) Ohota M, Ozaki Y, et al Circ J 2012;76:
16 Coronary tissue characterization Baseline Intravascular Ultrasound Characteristics (Follow up 30 ± 7 months) Vulnerable Stable Plaque (n = 10) Plaque (n = 143) p Vessel area, mm ± ± Lumen area, mm2 6.1 ± ± Plaque area, mm2 8.0 ± ± Plaque burden, % 60 ± 9 52 ± % diameter stenosis, % 35 ± 7 31 ± % area stenosis, % 57 ± 8 52 ± Eccentricity rate 0.70 ± ± Remodeling index 1.30 ± ± % fibrous area, % 23 ± 6 47 ± 14 < % lipid area, % 72 ± ± 16 < Sano K, Kawasaki M et al. J Am Coll Cardio 2006;47:734
17 VH-TCFA in ACS and Stable Angina VH-TCFA definition: 1) NC >10% without overlying fibrous tissue 2) PAV >40% Rodriguez-Granillo GA, et al. J Am Coll Cardiol 2005;46:
18 Witnessed Coronary Plaque Rupture during Cardiac Catheterization Gonzalo N, et al. JACC imaging 2011;4:437-8
19 All 30 pts with STEMI Kubo T. et al. J Am Coll Cardiol 2007;50:933-9
20 Role of OCT in Assessing Plaque Rupture/ Erosion CT-angiographic characteristics of RFC-ACS include lowattenuation plaques and positive plaque remodelling, features associated with IFC-ACS have not been previously described. We sought to determine whether CT characteristics of IFC- ACS lesions differed from RFC-ACS using OCT to identify erosions. Multi-modality approach used to leverage advantages of different invasive imaging tools
21 Baseline Clinical and Angiographic Characteristics RFC-ACS IFC-ACS Stable Angina p-value Patients (n) Age (years) Male (n, %) NSTEMI (n, %) UAP (n, %) Stable Angina (n, %) 64.8± (93) 16 (53) 14 (47) ±7.5 9 (69) 6 (46) 7 (54) ± (96) (100) Diabetes (n, %) Hypertension (%) Hypercholesterolemia(%) Smokers (n, %) Non-smoker Ex-smoker Current smoker 11 (37) 14 (47) 14 (47) 11 (37) 12 (40) 8 (27) 3 (23) 7 (54) 6 (46) 1 (8) 3 (23) 9 (69) 12 (41) 17 (59) 15 (51) 10 (35) 13 (48) 6 (21)
22 Baseline Angiographic Characteristics RFC-ACS IFC-ACS Stable Angina p-value Culprit Lesions (n) RCA/LAD/LCX (n, %) 30 13/ 16/ / 6/ / 16/ Lesion type (A/B1/B2/C, n) 1/ 12/ 16/ 1 1/ 5/ 7/ 0 3/ 15/ 10/ QCA - RD pre (mm) QCA - MLD pre (mm) 2.69± ± ± ± ± ± Non-culprit lesions in non-culprit vessel by MDCT RFC-ACS IFC-ACS Stable Angina p-value Non-Culprit Lesions (n) Average lesion severity (%) NCP < 30 HU (n, %) Spotty calcification (n, %) Positive Remodeling (n, %) 21 42±19 9 (43) 7 (33) 11 (52) 9 34±14 2 (22) 2 (22) 1 (11) 15 47±182 2 (13) 2 (13) 2 (13)
23 OCT RFC-ACS IFC-ACS Stable Angina p-value Lesion (n) Fibrous cap thickness (μm) 46±12 134±58 289± Lipid angle > 2 quads (n, %) 28 (93) 6 (46) 7 (24) TCFA (n, %) Thrombus (n, %) 28 (93) 30 (100) 3 (23) 13 (100) 2 (7) 4 (14) Thrombus Mural thrombus Protruding thrombus Yellow plaque White plaque Angioscopy RFC-ACS IFC-ACS Stable Angina p-value 26 (87) 15 (50) 11 (37) 25 (83) 5 (17) 13 (100) 10 (77) 3 (23) 9 (69) 4 (31) 4 (14) 3 (10) 1 (8) 17 (59) 12 (41)
24 IVUS RFC-ACS IFC-ACS Stable Angina p-value (ANOVA) Lesion (n) IVUS(mm 2 ) Vessel area pre 15.1± ± ± Lumen area pre 2.1± ± ± Plaque area pre 13.0± ± ± Prox. ref. vessel area 14.3± ± ± Distal. ref. vessel area 12.0± ± ± Remodeling index 1.14±0.11 A1)* 0.97±0.08 B1)* 0.95±0.11 C1)* p<0.05 in A1)* vs. B1)* and A1)* vs. C1)*
25 64-slice/ 320-slice MDCT RFC-ACS IFC-ACS Stable Angina p-value (ANOVA) Lesion (n) 64-slice MDCT (n,%) NCP < 30 HU (LAP) Spotty calcification Large calcification Remodelling index Positive remodelling LAP & PR (90) 24 (80) 3 (10) 13 5 (38) 3 (23) 1 (8) 29 4 (14) 7 (24) 18 (62) 1.11±0.07 A2)* 1.01±0.08 B2)* 1.01±0.07 C2)* 28 (93) 27 (90) 3 (23) 2 (9) 4 (14) 1 (3) p<0.05 in A2)* vs. B2)* and A2)* vs. C2)*
26 Future Directions - While approximately one-third of lesions responsible for major coronary thrombi on pathological analysis are secondary to plaque erosions, it is reasonable to presume that non-disrupted culprit lesions (IFC-ACS) in our study would represent plaque erosions. - We found no unique CT features of non-ruptured culprit lesions to enable their clear distinction from stable lesions - Identification and study of lesions at risk of erosion continues to rely on invasive intracoronary imaging
27 Imaging Modalities to Identify Morphological Features of Coronary Plaque Instability CT IVUS IVUS VH Palpograpy OCT Angioscopy 1 Fibrous cap thickness Necrotic/lipid core ± ± Lumen obstruction ± Outward remodeling Inflammation Calcification (spotty) Yellow plaque Strain Low attenuation Feyter PJ, Nieman K. Editorial; Failure of CT coronary imaging to identify plaque erosion; a resetting of expectations. Eur Heart J 2011;32:
28 Conclusions Invasive intracoronary imaging has revolutionized our in vivo understanding of the pathogenesis of atherosclerotic plaque rupture and erosion The different modalities provide complementary information of different aspects of plaque risk and behaviour The non-invasive identification of lesions at risk of erosion remains challenging and a fertile area for future research
Yukio Ozaki, M Okumura, TF Ismail 2, S Motoyama, H. Naruse, K. Hattori, H. Kawai, M. Sarai, J. Ishii, Jagat Narula 3
Culprit Lesion Characteristics in Acute Coronary Syndrome and Stable Angina Assessed by Optical Coherence Tomography (OCT), Angioscopy, IVUS and Multidetector Computed Tomography (MDCT) Yukio Ozaki, M
More informationImaging Atheroma The quest for the Vulnerable Plaque
Imaging Atheroma The quest for the Vulnerable Plaque P.J. de Feijter 1. Department of Cardiology 2. Department of Radiology Coronary Heart Disease Remains the Leading Cause of Death in the U.S, Causing
More informationInvasive Coronary Imaging Modalities for Vulnerable Plaque Detection
Invasive Coronary Imaging Modalities for Vulnerable Plaque Detection Gary S. Mintz, MD Cardiovascular Research Foundation New York, NY Greyscale IVUS studies have shown Plaque ruptures do not occur randomly
More informationAssessment of plaque morphology by OCT in patients with ACS
Assessment of plaque morphology by OCT in patients with ACS Takashi Akasaka, M.D. Department of Cardiovascular Medicine Wakayama, Japan Unstable plaque Intima Lipid core Plaque rupture and coronary events
More informationImaging Overview for Vulnerable Plaque: Data from IVUS Trial and An Introduction to VH-IVUS Imgaging
Imaging Overview for Vulnerable Plaque: Data from IVUS Trial and An Introduction to VH-IVUS Imgaging Gary S. Mintz,, MD Cardiovascular Research Foundation New York, NY Today, in reality, almost everything
More informationHigh-risk vulnerable plaques. Kostis Raisakis G.Gennimatas General Hospital of Athens
High-risk vulnerable plaques. Kostis Raisakis G.Gennimatas General Hospital of Athens Overview: 1 Definition-Pathology 2 3 Diagnostic Strategies Invasive Non Invasive Prognostic Value of Detection 4 Treatment
More informationCan We Identify Vulnerable Patients & Vulnerable Plaque?
Can We Identify Vulnerable Patients & Vulnerable Plaque? We Know Enough to Treat High-Risk Lesions? Takashi Akasaka, MD, PhD Department of Cardiovascular Medicine, Japan Disclosure Statement of Financial
More informationCulprit Lesion Remodeling and Long-term (> 5years) Prognosis in Patients with Acute Coronary Syndrome
Culprit Lesion Remodeling and Long-term (> 5years) Prognosis in Patients with Acute Coronary Syndrome Hiroyuki Okura*, MD; Nobuya Matsushita**,MD Kenji Shimeno**, MD; Hiroyuki Yamaghishi**, MD Iku Toda**,
More informationOCT; Comparative Imaging Results with IVUS, VH and Angioscopy
OCT; Comparative Imaging Results with IVUS, VH and Angioscopy Takashi Akasaka, M.D. Department of Cardiovascular Medicine Wakayama, Japan Comparison among coronary imaging techniques OCT IVUS MRI CAG Angioscopy
More informationCardiovascular Research Foundation and Columbia University Medical Center, New York.
Virtual Histology Intravascular Ultrasound Analysis of Non-culprit Attenuated Plaques Detected by Grayscale Intravascular Ultrasound in Patients with Acute Coronary Syndromes Xiaofan Wu, Akiko Maehara,
More informationFailure of positive. Recanalization and CTO formation. TCFA rupture with (fatal) thrombotic occlusion. TCFA Lipid pool
Vulnerable Plaque features on coronary CT Jin Ho Choi, MD, PhD Department of Internal Medicine, Emergency Medicine Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea IPS /
More informationAssessment of vulnerable plaque by OCT
Assessment of vulnerable plaque by OCT Comparison with histology and possible clinical applications Takashi Akasaka, M.D. Department of Cardiovascular Medicine Wakayama, Japan Identification of vulnerable
More informationOCT Findings: Lesson from Stable vs Unstable Plaques
ANGIOPLASTY SUMMIT TCTAP 2010 Imaging Workshop OCT Findings: Lesson from Stable vs Unstable Plaques Giulio Guagliumi MD Ospedali Riuniti di Bergamo, Italy DISCLOSURE OF FINANCIAL INTERESTS Consultant Boston
More informationCT Imaging of Atherosclerotic Plaque. William Stanford MD Professor-Emeritus Radiology University of Iowa College of Medicine Iowa City, IA
CT Imaging of Atherosclerotic Plaque William Stanford MD Professor-Emeritus Radiology University of Iowa College of Medicine Iowa City, IA PREVALENCE OF CARDIOVASCULAR DISEASE In 2006 there were 80 million
More informationCLINICAL APPLICATIONS OF OPTICAL COHERENCE TOMOGRAPHY. Konstantina P. Bouki, FESC 2 nd Department of Cardiology General Hospital Of Nikea, Pireaus
CLINICAL APPLICATIONS OF OPTICAL COHERENCE TOMOGRAPHY Konstantina P. Bouki, FESC 2 nd Department of Cardiology General Hospital Of Nikea, Pireaus OPTICAL COHERENCE TOMOGRAPHY (OCT) IVUS and OCT IVUS OCT
More informationPlaque Characteristics in Coronary Artery Disease. Chourmouzios Arampatzis MD, PhD, FESC
Plaque Characteristics in Coronary Artery Disease Chourmouzios Arampatzis MD, PhD, FESC Disclosure Statement of Financial Interest Regarding this Presentation NONE Atherosclerosis Model proposed by Stary
More informationAssessment of Vulnerable Plaque by IVUS and VH-IVUS
Assessment of Vulnerable Plaque by IVUS and VH-IVUS Akiko Maehara, MD Director of Intravascular Imaging & Physiology Core Laboratories Associate Director of MRI/MDCT Core Laboratory Cardiovascular Research
More informationVulnerable Plaque Pathophysiology, Detection, and Intervention. VP: A Local Problem or Systemic Disease. Erling Falk, Denmark
Vulnerable Plaque Pathophysiology, Detection, and Intervention VP: A Local Problem or Systemic Disease Erling Falk, Denmark Vulnerable Plaque Pathophysiology, Detection, and Intervention VP: A Local Problem
More information1st Department of Cardiology, University of Athens, Hippokration Hospital, Athens, Greece
Konstantinos Toutouzas, Maria Riga, Antonios Karanasos, Eleftherios Tsiamis, Andreas Synetos, Maria Drakopoulou, Chrysoula Patsa, Georgia Triantafyllou, Aris Androulakis, Christodoulos Stefanadis 1st Department
More informationPathology of Vulnerable Plaque Angioplasty Summit 2005 TCT Asia Pacific, Seoul, April 28-30, 2005
Pathology of Vulnerable Plaque Angioplasty Summit 25 TCT Asia Pacific, Seoul, April 28-3, 25 Renu Virmani, MD CVPath, A Research Service of the International Registry of Pathology Gaithersburg, MD Plaque
More informationNoninvasive Coronary Imaging: Plaque Imaging by MDCT
Coronary Physiology & Imaging Summit 2007 Noninvasive Coronary Imaging: Plaque Imaging by MDCT Byoung Wook Choi Department of Radiology Yonsei University, Seoul, Korea Stary, H. C. et al. Circulation
More informationΚλινική Χρήση IVUS και OCT PERIKLIS A. DAVLOUROS ASSOCIATE PROFESSOR OF CARDIOLOGY INVASIVE CARDIOLOGY & CONGENITAL HEART DISEASE
Κλινική Χρήση IVUS και OCT PERIKLIS A. DAVLOUROS ASSOCIATE PROFESSOR OF CARDIOLOGY INVASIVE CARDIOLOGY & CONGENITAL HEART DISEASE Conflict of interest None to declare While IVUS is the most used intravascular
More informationState of the Art. Advances in Cardiovascular Imaging. ESC Congres Stockholm September 1, 2010 Frank E. Rademakers, MD, PhD, FESC
State of the Art Advances in Cardiovascular Imaging ESC Congres Stockholm September 1, 2010 Frank E. Rademakers, MD, PhD, FESC Coronary Artery Disease Content Patho Physiology Imaging requirements Economical
More informationCan IVUS Define Plaque Features that Impact Patient Care?
Can IVUS Define Plaque Features that Impact Patient Care? A Pichard L Satler, K Kent, R Waksman, W Suddath, N Bernardo, N Weissman, M Angelo, D Harrington, J Lindsay, J Panza. Washington Hospital Center
More informationGary S. Mintz,, MD. IVUS Observations in Acute (vs Chronic) Coronary Artery Disease: Structure vs Function
Gary S. Mintz,, MD IVUS Observations in Acute (vs Chronic) Coronary Artery Disease: Structure vs Function Important IVUS Observations: Remodeling Originally used (first by Glagov) ) to explain atherosclerosis
More information2yrs 2-6yrs >6yrs BMS 0% 22% 42% DES 29% 41% Nakazawa et al. J Am Coll Cardiol 2011;57:
Pathology of In-stent Neoatherosclerosis in BMS and DES 197 BMS, 103 SES, and 106 PES with implant duration >30 days The incidence of neoatherosclerosis was significantly greater in DES (31%) than BMS
More informationThe PROSPECT Trial. A Natural History Study of Atherosclerosis Using Multimodality Intracoronary Imaging to Prospectively Identify Vulnerable Plaque
The PROSPECT Trial Providing Regional Observations to Study Predictors of Events in the Coronary Tree A Natural History Study of Atherosclerosis Using Multimodality Intracoronary Imaging to Prospectively
More informationPathology of Coronary Artery Disease
Pathology of Coronary Artery Disease Seth J. Kligerman, MD Pathology of Coronary Artery Disease Seth Kligerman, MD Assistant Professor Medical Director of MRI University of Maryland Department of Radiology
More informationUsefulness of OCT during coronary intervention
Usefulness of OCT during coronary intervention Takashi Akasaka, M.D. Department of Cardiovascular Medicine Wakayama, Japan Predictors at 12 Months of Stent Thrombosis and Target Lesion Revascularization
More informationLeft main coronary artery (LMCA): The proximal segment
Anatomy and Pathology of Left main coronary artery G Nakazawa Tokai Univ. Kanagawa, Japan 1 Anatomy Difinition Left main coronary artery (LMCA): The proximal segment RCA AV LAD LM LCX of the left coronary
More informationCoronary Artery Thermography
Coronary Artery Thermography The 10th Anniversary, Interventional Vascular Therapeutics Angioplasty Summit 2005 TCT Asia Pacific Christodoulos Stefanadis Professor of Cardiology Athens Medical School In
More informationIVUS Analysis. Myeong-Ki. Hong, MD, PhD. Cardiac Center, Asan Medical Center University of Ulsan College of Medicine, Seoul, Korea
IVUS Analysis Myeong-Ki Hong, MD, PhD Cardiac Center, Asan Medical Center University of Ulsan College of Medicine, Seoul, Korea Intimal disease (plaque) is dense and will appear white Media is made of
More informationChapter 43 Noninvasive Coronary Plaque Imaging
hapter 43 Noninvasive oronary Plaque Imaging NIRUDH KOHLI The goal of coronary imaging is to define the extent of luminal narrowing as well as composition of an atherosclerotic plaque to facilitate appropriate
More informationLe espressioni della placca che preoccupano il clinico: progressione o vulnerabilità? CardioLUCCA Marzo 2017
Le espressioni della placca che preoccupano il clinico: progressione o vulnerabilità? CardioLUCCA Marzo 2017 F Prati San Giovanni H. and CLI Foundation, Rome Euro Image Research Che cosa preoccupa il cardiologo
More informationInvasive Evaluation of High Risk or Vulnerable Plaque A Powerful Tool to Address Potential Pharmacological Agents? Jagat Narula, MD PhD MACC
Invasive Evaluation of High Risk or Vulnerable Plaque A Powerful Tool to Address Potential Pharmacological Agents? Jagat Narula, MD PhD MACC No Conflicts of Interest to Declare Histological Signatures
More informationThe PROSPECT Trial. A Natural History Study of Atherosclerosis Using Multimodality Intracoronary Imaging to Prospectively Identify Vulnerable Plaque
The PROSPECT Trial Providing Regional Observations to Study Predictors of Events in the Coronary Tree A Natural History Study of Atherosclerosis Using Multimodality Intracoronary Imaging to Prospectively
More informationFESC, FACC, MAHA, MSCAI, MEAPSI, ESH
«Απεικόνιση και φυσιολογία στο αιμοδυναμικό εργαστήριο». Eυάλωτη αθηρωματική πλάκα. Πού βρισκόμαστε? Ηλίας Α. Σανίδας MD, PhD, FESC, FACC, MAHA, MSCAI, MEAPSI, ESH Specialist Επεμβατικός Kαρδιολόγος Επιμελητής,
More informationMedical sciences 1 (2017) 1 9
Medical sciences 1 (2017) 1 9 TISSUE CHARACTERISTICS OF CULPRIT CORONARY LESIONS IN ACUTE CORONARY SYNDROME AND TARGET CORONARY LESIONS IN STABLE ANGINA PECTORIS: VIRTUAL HISTOLOGY AND INTRAVASCULAR ULTRASOUND
More informationas a Mechanism of Stent Failure
In-Stent t Neoatherosclerosis e osc e os s as a Mechanism of Stent Failure Soo-Jin Kang MD., PhD. University of Ulsan College of Medicine, Heart Institute Asan Medical Center, Seoul, Korea Disclosure I
More informationCharacterization of coronary plaques with combined use of intravascular ultrasound, virtual histology and optical coherence tomography
Heart International 2010; volume 5:e12 Characterization of coronary plaques with combined use of intravascular ultrasound, virtual histology and optical coherence tomography Guillermo Sánchez-Elvira, 1
More informationCottrell Memorial Lecture. Has Reversing Atherosclerosis Become the New Gold Standard in the Treatment of Cardiovascular Disease?
Cottrell Memorial Lecture Has Reversing Atherosclerosis Become the New Gold Standard in the Treatment of Cardiovascular Disease? Stephen Nicholls MBBS PhD @SAHMRI_Heart Disclosures Research support: AstraZeneca,
More informationReview Article Optical Coherence Tomography Imaging in Acute Coronary Syndromes
SAGE-Hindawi Access to Research Cardiology Research and Practice Volume 2011, Article ID 312978, 7 pages doi:10.4061/2011/312978 Review Article Optical Coherence Tomography Imaging in Acute Coronary Syndromes
More informationCHAPTER (2) THE VULNERABLE PLAQUE
CHAPTER (2) THE VULNERABLE PLAQUE UNSTABLE OR HIGH RISK ATHEROSCLEROTIC PLAQUE - Definition and Composition - Plaque Destabilization and Disruption - Fate of Disrupted Plaque - Clinical Presentation -
More informationOptical Coherence Tomography for Intracoronary Imaging
Optical Coherence Tomography for Intracoronary Imaging Lorenz Räber Stephan Windecker Department of Cardiology Swiss Cardiovascular Center and Clinical Trials Unit Bern Bern University Hospital, Switzerland
More informationImaging the Vulnerable Plaque. David A. Dowe, MD Atlantic Medical Imaging
Imaging the Vulnerable Plaque David A. Dowe, MD Atlantic Medical Imaging Why is this so important? The Acute Situation Coronary disease-important Diagnosis of cardiovascular disease cost $148 billion in
More informationCoronary plaque erosion: a clinical case. Dr. Giampaolo Niccoli, MD, PhD, FESC Institute of Cardiology Catholic University, Rome, Italy
Coronary plaque erosion: a clinical case, MD, PhD, FESC Institute of Cardiology Catholic University, Rome, Italy Coronary plaque erosion: a clinical case B.M. Age: 59 years Sex: female. Cardiological risk
More informationFrom the Vulnerable Atherosclerotic Plaque to CAD Management
33 rd Panhellenic Congress of Cardiology Athens, November 1-3, 2012 From the Vulnerable Atherosclerotic Plaque to CAD Management Filippos Triposkiadis, MD, FESC, FACC Professor of Cardiology Director,
More informationQue nos puede aportar el OCT intracoronario
XXXI Jornadas SOLACI. 10ª Región CONOSUR LIIIº Congreso Chileno de Cardiología y Cirugía Cardiovascular Hotel Patagónico. Puerto Varas. Chile (30 Nov 1 Dic 2016) Que nos puede aportar el OCT intracoronario
More informationactually rupture! Challenges to the vulnerable plaque concept
An Update on the Pathogenesis of the Acute Coronary Syndromes Peter Libby Brigham & Women s Hospital Harvard Medical School ADVANCES IN HEART DISEASE University of California San Francisco December 20,
More informationImpact of Body Mass Index and Metabolic Syndrome on the Characteristics of Coronary Plaques Using Computed Tomography Angiography
Impact of Body Mass Index and Metabolic Syndrome on the Characteristics of Coronary Plaques Using Computed Tomography Angiography Cardiovascular Division, Faculty of Medicine, University of Tsukuba Akira
More informationCoronary Artery Imaging. Suvipaporn Siripornpitak, MD Inter-hospital Conference : Rajavithi Hospital
Coronary Artery Imaging Suvipaporn Siripornpitak, MD Inter-hospital Conference : Rajavithi Hospital Larger array : cover scan area Detector size : spatial resolution Rotation speed : scan time Retrospective
More informationSpotty Calcification as a Marker of Accelerated Progression of Coronary Atherosclerosis : Insights from Serial Intravascular Ultrasound
Spotty Calcification as a Marker of Accelerated Progression of Coronary Atherosclerosis : Insights from Serial Intravascular Ultrasound Department of Cardiovascular Medicine Heart and Vascular Institute
More informationPathology of the Vulnerable Plaque
Journal of the American College of Cardiology Vol. 47, No. 8 Suppl C 2006 by the American College of Cardiology Foundation ISSN 0735-1097/06/$32.00 Published by Elsevier Inc. doi:10.1016/j.jacc.2005.10.065
More informationEvaluation of Intermediate Coronary lesions: Can You Handle the Pressure? Jeffrey A Southard, MD May 4, 2013
Evaluation of Intermediate Coronary lesions: Can You Handle the Pressure? Jeffrey A Southard, MD May 4, 2013 Disclosures Consultant- St Jude Medical Boston Scientific Speaker- Volcano Corporation Heart
More informationInsights in Thrombosis and In-Stent Restenosis
Clinical Value of OCT Insights in Thrombosis and In-Stent Restenosis Fernando Alfonso MD, PhD, FESC Interventional Cardiology. Cardiovascular Institute. Clinico San Carlos University Hospital. Madrid.
More informationOCT. molecular imaging J Jpn Coll Angiol, 2008, 48: molecular imaging MRI positron-emission tomography PET IMT
48 6 CT MRI PET OCT molecular imaging J Jpn Coll Angiol, 2008, 48: 456 461 atherosclerosis, imaging gold standard computed tomography CT magnetic resonance imaging MRI CT B intima media thickness IMT B
More informationBetween Coronary Angiography and Fractional Flow Reserve
Visual-Functional Mismatch Between Coronary Angiography and Fractional Flow Reserve Seung-Jung Park, MD., PhD. University of Ulsan, College of Medicine Asan Medical Center, Seoul, Korea Visual - Functional
More informationOptical Coherence Tomography (OCT): A New Imaging Tool During Carotid Artery Stenting
Chapter 6 Optical Coherence Tomography (OCT): A New Imaging Tool During Carotid Artery Stenting Shinichi Yoshimura, Masanori Kawasaki, Kiyofumi Yamada, Arihiro Hattori, Kazuhiko Nishigaki, Shinya Minatoguchi
More informationNon-invasive Plaque Imaging
Characterization of Coronary Atherosclerotic Plaques Using CTA Koen Nieman, MD Erasmus University Medical Center Thoraxcenter, dept. of Cardiology Dept. of Radiology Rotterdam, The Netherlands Massachusetts
More informationOCT-Based Diagnosis and Management of STEMI Associated With Intact Fibrous Cap
JACC: CARDIOVASCULAR IMAGING VOL. 6, NO. 3, 2013 2013 BY THE AMERICAN COLLEGE OF CARDIOLOGY FOUNDATION ISSN 1936-878X/$36.00 PUBLISHED BY ELSEVIER INC. http://dx.doi.org/10.1016/j.jcmg.2012.12.007 CONCEPTS
More informationAssessment of Culprit Lesion Morphology in Acute Myocardial Infarction
Journal of the American College of Cardiology Vol. 50, No. 10, 2007 2007 by the American College of Cardiology Foundation ISSN 0735-1097/07/$32.00 Published by Elsevier Inc. doi:10.1016/j.jacc.2007.04.082
More informationTissue Characterization of Coronary Plaques Using Intravascular Ultrasound/Virtual Histology
REVIEW Korean Circulation J 2006;36:553-558 ISSN 1738-5520 c 2006, The Korean Society of Circulation Tissue Characterization of Coronary Plaques Using Intravascular Ultrasound/Virtual Histology Jang-Ho
More information대한심장학회춘계학술대회 Satellite Symposium
대한심장학회춘계학술대회 Satellite Symposium Coronary Plaque Regression and Compositional Changes by Lipid-Lowering Therapy: IVUS Substudy in Livalo (Pitavastatin) in Acute Myocardial Infarction Study (LAMIS) Livalo
More informationThe Dynamic Nature of Coronary Artery Lesion Morphology Assessed by Serial Virtual Histology Intravascular Ultrasound Tissue Characterization
Journal of the American College of Cardiology Vol. 55, No. 15, 2010 2010 by the American College of Cardiology Foundation ISSN 0735-1097/10/$36.00 Published by Elsevier Inc. doi:10.1016/j.jacc.2009.07.078
More informationIntervention: How and to which extent is technology helping us?
Cardiological Society of India Congress 12th February 2016 Chennai, India Intervention: How and to which extent is technology helping us? SIMONE BISCAGLIA MD CARDIOVASCULAR INSTITUTE, FERRARA, ITALY Introduction
More informationCatch-up Phenomenon: Insights from Pathology
Catch-up Phenomenon: Insights from Pathology Michael Joner, MD CVPath Institute Inc. Gaithersburg, MD USA Path Lessons learned from the BMS and DES (1 st Gen) era Neointimal Thickness [mm] In Stent Re
More informationCalcified nodule as a cause of myocardial infarction with nonobstructive
www.edoriumjournals.com CASE REPORT PEER REVIEWED OPEN ACCESS Calcified nodule as a cause of myocardial infarction with nonobstructive coronary artery disease Kaitlyn E. Dugan, Akiko Maehara, Raymond Y.
More informationJournal of Cardiovascular Emergencies 2016;2(4): DOI: /jce
Journal of Cardiovascular Emergencies 2016;2(4):173-184 DOI: 10.1515/jce-2016-0028 JOURNAL OF CARDIOVASCULAR EMERGENCIES ORIGINAL RESEARCH Assessment of Coronary Plaque Vulnerability in Acute Coronary
More informationDefining Plaque Composition by CTA: The Latest Tool to Monitor Therapy?
Defining Plaque Composition by CTA: The Latest Tool to Monitor Therapy? John McB. Hodgson, M.D., FSCAI Chairman, Department of Cardiology Geisinger Health System Wilkes Barre,, Pa Disclosure Information
More informationPost PCI functional testing and imaging: case based lessons from FFR React
Post PCI functional testing and imaging: case based lessons from FFR React Joost Daemen, MD, PhD, FESC Optics in Cardiology 2018 April 21st, 2018 10.15 10.30h Disclosure Statement of Financial Interest
More informationMultislice Computed Tomographic Characteristics of Coronary Lesions in Acute Coronary Syndromes
Journal of the American College of Cardiology Vol. 50, No. 4, 2007 2007 by the American College of Cardiology Foundation ISSN 0735-1097/07/$32.00 Published by Elsevier Inc. doi:10.1016/j.jacc.2007.03.044
More informationPrediction of Acute Coronary Syndrome by Using Multislice Computed Tomography
Circulation Journal Official Journal of the Japanese Circulation Society http://www.j-circ.or.jp CONTROVERSIES IN CARDIOVASCULAR MEDICINE Prediction of Acute Coronary Syndrome by Using Multislice Computed
More informationBlood Vessels. Dr. Nabila Hamdi MD, PhD
Blood Vessels Dr. Nabila Hamdi MD, PhD ILOs Understand the structure and function of blood vessels. Discuss the different mechanisms of blood pressure regulation. Compare and contrast the following types
More information04RC2. The biology of vulnerable plaques. Jozef L. Van Herck 1, Christiaan J. Vrints 1, Arnold G. Herman 2
04RC2 The biology of vulnerable plaques Jozef L. Van Herck 1, Christiaan J. Vrints 1, Arnold G. Herman 2 1 Department of Cardiology, Antwerp University Hospital, Edegem, Belgium 2 Department of Pharmacology,
More informationJournal of the American College of Cardiology Vol. 38, No. 1, by the American College of Cardiology ISSN /01/$20.
Journal of the American College of Cardiology Vol. 38, No. 1, 2001 2001 by the American College of Cardiology ISSN 0735-1097/01/$20.00 Published by Elsevier Science Inc. PII S0735-1097(01)01315-8 Coronary
More informationRole of Intravascular Ultrasound in Patients with Acute Myocardial Infarction
Review Article Print ISSN 1738-5520 On-line ISSN 1738-5555 Korean Circulation Journal Role of Intravascular Ultrasound in Patients with Acute Myocardial Infarction Young Joon Hong, MD, Youngkeun Ahn, MD,
More informationOptical Coherence Tomography
Optical Coherence Tomography Disclosure Information Demetrius Lopes MD The following relationships exist related to this presentation: University Grant/Research Support: Rush University Industry Grant
More informationVulnerable Plaque. Atherothrombosis
Vulnerable Plaque Nuove acquisizioni sull'aterosclerosi: placca vulnerabile Marina Camera Dip. Scienze Farmacologiche, Facoltà di Farmacia, Università degli Studi di Milano & Laboratorio di Biologia Cellulare
More informationHead-to-Head Comparison of Coronary Plaque Evaluation Between Multislice Computed Tomography and Intravascular Ultrasound Radiofrequency Data Analysis
JACC: CARDIOVASCULAR INTERVENTIONS VOL. 1, NO. 2, 2008 2008 BY THE AMERICAN COLLEGE OF CARDIOLOGY FOUNDATION ISSN 1936-8798/08/$34.00 PUBLISHED BY ELSEVIER INC. DOI: 10.1016/j.jcin.2008.01.007 Head-to-Head
More informationTVA_C02.qxd 8/8/06 10:27 AM Page 19 PART 2. Pathology
TVA_C2.qxd 8/8/6 :27 AM Page 19 2 PART 2 Pathology TVA_C2.qxd 8/8/6 :27 AM Page TVA_C2.qxd 8/8/6 :27 AM Page 21 2 CHAPTER 2 The pathology of vulnerable plaque Renu Virmani, Allen P Burke, James T Willerson,
More informationCARDIAC IMAGING FOR SUBCLINICAL CAD
CARDIAC IMAGING FOR SUBCLINICAL CAD WHY DON'T YOU ADOPT MORE SMART TECHNIQUE? Whal Lee, M.D. Seoul National University Hospital Department of Radiology We are talking about Coronary artery Calcium scoring,
More informationIVUS Virtual Histology. Listening through Walls D. Geoffrey Vince, PhD The Cleveland Clinic Foundation
IVUS Virtual Histology Listening through Walls D. Geoffrey Vince, PhD Disclosure VH is licenced to Volcano Therapeutics Grant funding from Pfizer, Inc. Grant funding from Boston-Scientific Most Myocardial
More informationQuinn Capers, IV, MD
Heart Attacks Mended Hearts Presentation, January, 2017 Quinn Capers, IV, MD Associate Professor of Medicine (Cardiovascular Medicine) Director, Transradial Coronary Interventions Division of Cardiovascular
More informationOCT GUIDED TREATMENT OF CALCIFIED LESIONS RICHARD SHLOFMITZ, MD CHAIRMAN OF DEPT. OF CARDIOLOGY ST. FRANCIS HOSPITAL ROSLYN, NEW YORK
OCT GUIDED TREATMENT OF CALCIFIED LESIONS RICHARD SHLOFMITZ, MD CHAIRMAN OF DEPT. OF CARDIOLOGY ST. FRANCIS HOSPITAL ROSLYN, NEW YORK Disclosure Statement of Financial Interest Within the past 12 months,
More informationAddressing Vascular Plaque Ruptures
Transcript Details This is a transcript of an educational program accessible on the ReachMD network. Details about the program and additional media formats for the program are accessible by visiting: https://reachmd.com/programs/medical-breakthroughs-from-penn-medicine/addressing-vascularplaque-ruptures/3131/
More informationMultimodality Imaging Atlas of Coronary Atherosclerosis
JCC: CRDIOVSCUR IMGING VO. 3, NO. 8, 2010 2010 BY THE MERICN COEGE OF CRDIOOGY FOUNDTION ISSN 0735-1097/$36.00 PUBISHED BY ESEVIER INC. DOI:10.1016/j.jcmg.2010.06.006 IMGING VIGNETTE Multimodality Imaging
More informationCPIS So-Yeon Choi, MD., PhD. Department of Cardiology Ajou University School of MedicineSuwon, Korea
So-Yeon Choi, MD., PhD. Department of Cardiology Ajou University School of MedicineSuwon, Korea Coronary Artery Imaging The ideal coronary imaging technology would be capable of identifying not only vessel
More informationMalaysian Healthy Ageing Society
Organised by: Co-Sponsored: Malaysian Healthy Ageing Society CAD INVESTIGATIONS PHYSIOLOGICAL / FUNCTIONAL VS ANATOMICAL / STRUCTURAL Disclosure iheal medical centre is a one stop cardiac centre with
More informationThe Site of Plaque Rupture in Native Coronary Arteries
Journal of the American College of Cardiology Vol. 46, No. 2, 2005 2005 by the American College of Cardiology Foundation ISSN 0735-1097/05/$30.00 Published by Elsevier Inc. doi:10.1016/j.jacc.2005.03.067
More informationA Novel Low Pressure Self Expanding Nitinol Coronary Stent (vprotect): Device Design and FIH Experience
A Novel Low Pressure Self Expanding Nitinol Coronary Stent (vprotect): Device Design and FIH Experience Juan F. Granada, MD Medical Director, Skirball Center for Cardiovascular Research The Cardiovascular
More informationPathophysiology of Cardiovascular System. Dr. Hemn Hassan Othman, PhD
Pathophysiology of Cardiovascular System Dr. Hemn Hassan Othman, PhD hemn.othman@univsul.edu.iq What is the circulatory system? The circulatory system carries blood and dissolved substances to and from
More informationWe are IntechOpen, the first native scientific publisher of Open Access books. International authors and editors. Our authors are among the TOP 1%
We are IntechOpen, the first native scientific publisher of Open Access books 3,350 108,000 1.7 M Open access books available International authors and editors Downloads Our authors are among the 151 Countries
More informationDESolve NX Trial Clinical and Imaging Results
DESolve NX Trial Clinical and Imaging Results Alexandre Abizaid, MD, PhD, Instituto Dante Pazzanese, Sao Paulo, Brazil On behalf of the DESolve Nx Trial Investigators Please refer to the TCT2014 App or
More informationAppearance of Lipid-Laden Intima and Neovascularization After Implantation of Bare-Metal Stents
Journal of the American College of Cardiology Vol. 55, No. 1, 2010 2010 by the American College of Cardiology Foundation ISSN 0735-1097/10/$36.00 Published by Elsevier Inc. doi:10.1016/j.jacc.2009.08.032
More informationImpact of Metabolic Syndrome on Tissue Characteristics of Angiographically Mild to Moderate Coronary Lesions
Journal of the American College of Cardiology Vol. 49, No. 11, 2007 2007 by the American College of Cardiology Foundation ISSN 0735-1097/07/$32.00 Published by Elsevier Inc. doi:10.1016/j.jacc.2006.12.028
More informationPlaque Shift vs. Carina Shift Prevalence and Implication
TCTAP 2013 Fellowship Course Left Main and Bifurcation PCI: Bifurcation PCI Plaque Shift vs. Carina Shift Prevalence and Implication Soo-Jin Kang, MD., PhD. Department of Cardiology, University of Ulsan
More informationCardiac CT Angiography
Cardiac CT Angiography Dr James Chafey, Radiologist Why do we need a better test for C.A.D? 1. CAD is the leading cause of death in the US CAD 31% Cancer 23% Stroke 7% 2. The prevalence of atherosclerosis
More informationClinical Value of OCT. Guidance for Coronary Stenting. Giulio Guagliumi, MD
Clinical Value of OCT Guidance for Coronary Stenting Giulio Guagliumi, MD 100 % Endovascular Imaging Indications of use 87.5 % 75 % 57.5 % 50 % 45 % 25 % 15 % 0 Lesion morphology Stent optimization Lesion
More informationPositive Vascular Remodeling in Culprit Coronary Lesion is Associated With Plaque Composition: An Intravascular Ultrasound-Virtual Histology Study
Original rticle http://dx.doi.org/.7/kcj...77 Print ISSN 738-55 On-line ISSN 738-5555 Korean Circulation Journal Vascular Remodeling in Culprit Coronary Lesion is ssociated With Plaque Composition: n Intravascular
More informationDr Rodney Itaki Lecturer Anatomical Pathology Discipline. University of Papua New Guinea School of Medicine & Health Sciences Division of Pathology
Arterial Diseases Dr Rodney Itaki Lecturer Anatomical Pathology Discipline University of Papua New Guinea School of Medicine & Health Sciences Division of Pathology Disease Spectrum Arteriosclerosis Atherosclerosis
More information