“…Studies of aortic atherosclerosis using NOGA have reported that SRAP can cause embolism in various organs. 12 , 13 , 15 , 17 , 18 This study showed that SRAP—especially in the ascending aorta and arch region—can be a major cause of ischemic stroke, including cortical or subcortical infarction ( Central Illustration ). Central Illustration Aortogenic Stroke: The Significant Contribution of Spontaneous Aortic Ruptured Plaques Spontaneous aortic ruptured plaques (SRAPs) in the aorta constantly blow out atheromatous materials and thrombi, which cause embolic strokes.…”
Section: Discussionmentioning
confidence: 95%
“…The evaluation of aortic plaques by NOGA has been described previously. 12 , 13 , 17 , 18 This includes ruptured plaque with a “puff-like” appearance and/or a “chandelier-like” appearance. 18 “Puff” rupture is defined as a ruptured plaque with white or white-yellow puff-like materials that easily blow out spontaneously, whereas “chandelier” rupture is defined as a ruptured plaque with materials that glisten in the light from the tip of the NOGA fiber catheter.…”
“…Studies of aortic atherosclerosis using NOGA have reported that SRAP can cause embolism in various organs. 12 , 13 , 15 , 17 , 18 This study showed that SRAP—especially in the ascending aorta and arch region—can be a major cause of ischemic stroke, including cortical or subcortical infarction ( Central Illustration ). Central Illustration Aortogenic Stroke: The Significant Contribution of Spontaneous Aortic Ruptured Plaques Spontaneous aortic ruptured plaques (SRAPs) in the aorta constantly blow out atheromatous materials and thrombi, which cause embolic strokes.…”
Section: Discussionmentioning
confidence: 95%
“…The evaluation of aortic plaques by NOGA has been described previously. 12 , 13 , 17 , 18 This includes ruptured plaque with a “puff-like” appearance and/or a “chandelier-like” appearance. 18 “Puff” rupture is defined as a ruptured plaque with white or white-yellow puff-like materials that easily blow out spontaneously, whereas “chandelier” rupture is defined as a ruptured plaque with materials that glisten in the light from the tip of the NOGA fiber catheter.…”
“…6) Therefore, it is necessary to consider the vulnerability of aortic plaques in patients with coronary artery disease. The number of NOGA-derived aortic plaques was significantly associated with composite cardiovascular events, including cerebral infarction and peripheral artery disease; 10) PCR detected by NOGA is more vulnerable and involved in a poor clinical outcome. 8) In the present case of AMI, vulnerable plaques in the coronary artery culprit lesion and the aorta were detected, in addition to the spread of systemic vulnerable atherosclerosis.…”
Section: Discussionmentioning
confidence: 97%
“…Following the PCI, NOGA for the coronary artery and aorta was performed. NOGA showed 2-degree yellow plaque without red thrombus at the stent site (Figure 1A) and a puffchandelier rupture (PCR), a vulnerable type of atheromatous plaque, [7][8][9][10][11] on the distal aortic arch (Figures 2A, 3A, Figure 4A; red arrow). The PCR observed by NOGA showed the scattering of atheromatous materials from the ruptured plaques by blood flow, and mobile plaque contents were also observed (Figure 3A).…”
Stabilization of aortic vulnerable plaques has not been fully elucidated. Non-obstructive general angioscopy (NOGA) is a novel method for the detailed evaluation of atheromatous plaques in the aortic intimal wall. A 57year-old man presenting with acute myocardial infarction underwent percutaneous coronary intervention (PCI). NOGA was performed for the evaluation of aortic atherosclerosis, and vulnerable puff-chandelier plaques in the aortic arch were identified. After a strictly controlled low-density lipoprotein cholesterol lowering therapy with a strong statin for 8 months after the primary PCI, NOGA revealed stabilized aortic plaques in the same lesions. Therefore, NOGA may be helpful in evaluating the effects of lipid-lowering therapy on aortic plaque stabilization.
“…Previous studies reported the incidence of SRAP as high as 80.9% in patients with or suspected of having coronary artery disease, but 45.8% of these incidents occurred below the diaphragmatic level. 8 In the EAST-NOGA (Evaluation of Atherosclerotic and Rupture Events by Non-obstructive General Angioscopy) study, 9 the presence of 12 or more aortic plaques was a significant predictor for composite end point events (including cardiovascular death, stroke, and myocardial infarction) during a median follow-up period of 13 months. The contribution of SRAPs to ischemic stroke, however, was still difficult to estimate.…”
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