Abstract:
OBJECTIVES:This study was conducted to assess the relations among intracoronary ultrasound, angiographic and histologic data obtained from patients with coronary artery disease successfully treated by directional coronary atherectomy. In addition, it was designed to elucidate whether some aspects of intravascular ultrasound or pathologic findings could predict a propensity to restenosis. BACKGROUND:Intracoronary ultrasound is a useful technique in guiding and assessing atherectomy. However, there is little information about the characterization of the different types of coronary plaques and the changes observed in them after resection. Furthermore, the follow-up ultrasound appearance of previously treated lesions remains undepicted. METHODS:Fifty-two patients (54 +/- 10 years old) were studied. All were successfully treated by atherectomy with the aid of intracoronary ultrasound guidance. Qualitative and quantitative ultrasound and angiographic variables were derived before and after resection. Quantitative histologic morphometric information was also obtained from the specimens. In 22 patients, a follow-up echoangiographic reevaluation was performed 6 +/- 4 months later. RESULTS:Echogenic plaques had a higher collagen and calcium content, whereas echolucent plaques had an increased level of fibrin, nuclei and lipids. Ultrasound plaque reduction after atherectomy was greater in echolucent (76 +/- 21%) than in echogenic plaques (60 +/- 18%; p < 0.05). That reduction correlated with the weight of the resected material (r = 0.62; p < 0.01). At follow-up study, 13 of 22 patients had angiographic and ultrasound evidence of restenosis. Most recurrent lesions had a stenotic three-layer appearance. The incidence of restenosis of primary lesions treated with atherectomy was higher in echolucent (100%) than in echogenic (33%) plaques. Similarly, a higher proportion of nuclear content in the resected material was observed in patients who developed restenosis (2.1 +/- 0.7%) than in patients who had late success after atherectomy (1.2 +/- 0.6%). CONCLUSIONS:Our findings suggest that echolucent plaques are easier to resect than are echogenic plaques but frequently develop restenosis. In contrast, the resection of echogenic plaques, although often incomplete, is associated with better long-term results.
journal_name
J Am Coll Cardioljournal_title
Journal of the American College of Cardiologyauthors
Suárez de Lezo J,Romero M,Medina A,Pan M,Pavlovic D,Vaamonde R,Hernández E,Melián F,López Rubio F,Marrero Jdoi
10.1016/0735-1097(93)90667-psubject
Has Abstract,Author List Incompletepub_date
1993-02-01 00:00:00pages
298-307issue
2eissn
0735-1097issn
1558-3597pii
0735-1097(93)90667-Pjournal_volume
21pub_type
杂志文章abstract:OBJECTIVES:This study was designed to identify macrophage-rich atherosclerotic plaque noninvasively by imaging the tissue uptake of long-circulating superparamagnetic nanoparticles with a positive contrast off-resonance imaging sequence (inversion recovery with ON-resonant water suppression [IRON]). BACKGROUND:The sud...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2008.03.063
更新日期:2008-08-05 00:00:00
abstract:OBJECTIVES:We assessed the hypothesis that changes in endothelial vasomotor function in response to optimized therapy for atherosclerotic coronary artery disease predict future cardiovascular events. BACKGROUND:Although endothelial vasomotor dysfunction is a predictor of cardiovascular events, it remains unclear wheth...
journal_title:Journal of the American College of Cardiology
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journal_title:Journal of the American College of Cardiology
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journal_title:Journal of the American College of Cardiology
pub_type: 临床试验,杂志文章
doi:10.1016/0735-1097(95)00139-q
更新日期:1995-07-01 00:00:00
abstract::Cardiovascular disease is the leading cause of mortality in the world, and the increasing burden is largely a consequence of modifiable behavioral risk factors that interact with genomics and the environment. Continuous cardiovascular health promotion and disease prevention throughout the lifespan is critical, and the...
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journal_title:Journal of the American College of Cardiology
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1016/0735-1097(96)00122-2
更新日期:1996-07-01 00:00:00
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journal_title:Journal of the American College of Cardiology
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journal_title:Journal of the American College of Cardiology
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更新日期:2006-08-15 00:00:00
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更新日期:2007-11-06 00:00:00
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更新日期:2008-08-26 00:00:00
abstract::Glycoprotein (GP) IIb/IIIa inhibitors are beneficial in unstable angina/non-ST-segment elevation myocardial infarction (UA/NSTEMI). In large trials, the GP IIb/IIIa inhibitors tirofiban and eptifibatide were each found to reduce the risk of death or myocardial infarction (MI) in these patients at 30 days. These agents...
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pub_type: 临床试验,杂志文章,随机对照试验,评审
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更新日期:2003-02-19 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2004-01-21 00:00:00
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更新日期:2006-10-03 00:00:00
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doi:10.1016/j.jacc.2009.04.080
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journal_title:Journal of the American College of Cardiology
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doi:10.1016/s0735-1097(83)80047-3
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更新日期:2005-09-06 00:00:00
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journal_title:Journal of the American College of Cardiology
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更新日期:2014-06-03 00:00:00
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journal_title:Journal of the American College of Cardiology
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doi:10.1016/j.jacc.2006.11.042
更新日期:2007-04-03 00:00:00
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更新日期:2013-08-20 00:00:00
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更新日期:2010-04-20 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(84)80277-6
更新日期:1984-06-01 00:00:00