Color of culprit lesion at 6 months after plain old balloon angioplasty versus stenting in patients with acute myocardial infarction

Ueda, Yasunori; Ohtani, Tomohito; Shimizu, Masahiko; Mizote, Isamu; Ohyabu, Jota; Hirayama, Atsushi

doi:10.1016/j.ahj.2004.05.034

Cited by 7 publications

(9 citation statements)

References 21 publications

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“…Therefore, the use of distal protection was not influenced by the results of angioscopic examination. Furthermore, as much as Ͼ85% interobserver and intraobserver reproducibility has been reported 33,34 for the angioscopic evaluations. Because we have excluded the patients with culprit vessel diameters Ͻ3.0 mm, the present findings may not apply to those patients.…”

Section: Study Limitationsmentioning

confidence: 95%

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Distal Protection Improved Reperfusion and Reduced Left Ventricular Dysfunction in Patients With Acute Myocardial Infarction Who Had Angioscopically Defined Ruptured Plaque

et al. 2005

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Background-Distal protection, in the Saphenous Vein Graft Angioplasty Free of Emboli (SAFER) trial, is demonstratedto prevent distal embolism in the percutaneous coronary intervention of saphenous vein graft. However, in the Enhanced Myocardial Efficacy and Recovery by Aspiration of Liberated Debris (EMERALD) trial, it was not effective in the percutaneous coronary intervention of native coronary arteries in patients with acute myocardial infarction (AMI). We hypothesized that its effectiveness would be determined by lesion characteristics. Therefore, we classified the type of culprit lesion by angioscopy and examined its influence on the effectiveness of distal protection, comparing patients with AMI treated with and without distal protection. Methods and Results-Consecutive patients with AMI treated without distal protection (nϭ110) who had angioscopically defined ruptured plaque. Distal embolization of plaque debris was detected more frequently in patients with ruptured plaque. These results suggest that microcirculation damage and left ventricular dysfunction are increased mainly by distal embolization of plaque debris rather than of thrombus.

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Section: Study Limitationsmentioning

confidence: 95%

“…32,33 Culprit lesions of acute MI have also been reported to have yellow plaque and thrombus; however, the plaque is ruptured with the protrusion of its contents, mixed with thrombus in some cases, but no obvious rupture is observed in others. 34,35 …”

Section: Angioscopic Appearance Of Diseased Svg and Culprit Lesions Omentioning

confidence: 99%

Distal Protection Improved Reperfusion and Reduced Left Ventricular Dysfunction in Patients With Acute Myocardial Infarction Who Had Angioscopically Defined Ruptured Plaque

et al. 2005

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“…The I/ R-induced endothelial dysfunction can be reversible for several months after AMI 19) . Recent studies showed that thrombus remains within the culprit coronary arteries for several months after MI 25) . Microthrombus and vasoactive mediators derived from the thrombus have a causative role in endothelial vasomotor dysfunction after MI [26][27][28] .…”

Section: Factors Related To the Trans-myocardial Gradient Of Pai-1 6 mentioning

confidence: 99%

Myocardial Production of Plasminogen Activator Inhibitor-1 is Associated with Coronary Endothelial and Ventricular Dysfunction after Acute Myocardial Infarction

Shimizu

Uematsu

Yoshizaki

et al. 2016

J Atheroscler Thromb

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“…In the assessment of the healing process of unstable yellow plaques after stenting by using angioscopy, Ueda et al [34] demonstrated that bare-metal stent implantation in patients with acute myocardial infarction led to the disappearance of yellow color at a significantly higher rate than balloon angioplasty. The mechanisms of yellow color disappearance might be the coverage of the lipid core by neointima, the regression of the lipid core, or both.…”

Section: Unstable Plaque and Coronary Interventionmentioning

confidence: 99%

Angioscopy and Unstable Coronary Plaques: Findings Beyond Thrombus

Kubo

2011

Curr Cardiovasc Imaging Rep

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Recent advances in intravascular imaging have significantly improved the ability to detect high-risk, or vulnerable, plaque in vivo. Coronary angioscopy is especially suitable for identifying thrombus, plaque disruption, and variations in color of the coronary arterial wall. Intracoronary thrombus and disruption of glistening yellow plaque at the site of culprit lesions are seen more commonly in patients with acute myocardial infarction and unstable angina than in patients with stable angina. Acute coronary syndromes occur more frequently in patients with yellow plaque than in those with white plaques. Angioscopy can also be used to assess the effect of preventive treatment. Lipid-lowering therapies with statin change lesions from yellow to white, suggesting plaque stabilization. Coronary angioscopy provides a great opportunity to understand pathophysiology of acute coronary syndrome and would play an important role to evaluate the risk of the future coronary events.

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Color of culprit lesion at 6 months after plain old balloon angioplasty versus stenting in patients with acute myocardial infarction

Cited by 7 publications

References 21 publications

Distal Protection Improved Reperfusion and Reduced Left Ventricular Dysfunction in Patients With Acute Myocardial Infarction Who Had Angioscopically Defined Ruptured Plaque

Distal Protection Improved Reperfusion and Reduced Left Ventricular Dysfunction in Patients With Acute Myocardial Infarction Who Had Angioscopically Defined Ruptured Plaque

Myocardial Production of Plasminogen Activator Inhibitor-1 is Associated with Coronary Endothelial and Ventricular Dysfunction after Acute Myocardial Infarction

Angioscopy and Unstable Coronary Plaques: Findings Beyond Thrombus

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