Comparison of angioscopy, intravascular ultrasound imaging and quantitative coronary angiography in predicting clinical outcome after coronary intervention in high risk patients

Feld, Sheila; Ganim, Mazen; Carell, Edgar S.; Kjellgren, Olle; Kirkeeide, Richard L.; Vaughn, William K.; Kelly, Ron C.; McGhie, A. Iain; Kramer, Nancy; Loyd, Dan; Anderson, H. Vernon; Schroth, George; Smalling, Richard W.

doi:10.1016/0735-1097(96)00102-7

Cited by 59 publications

(41 citation statements)

References 34 publications

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“…In the present case, angioscopy was not only more efficient in detecting intracoronary thrombus than angiography and IVUS, [20][21][22][23] but also allowed detailed observation of the degree of dilatation of the implanted coronary stent. Only intracoronary angioscopy could detect the cause of the repeat subacute thrombosis after stenting that resulted in AMI.…”

Section: Discussionmentioning

confidence: 91%

Usefulness of Intracoronary Angioscopy for Elucidating the Cause of Subacute Thrombosis After Stenting

et al. 2001

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Stent thrombosis is rare with anti-platelet therapy, which consists of aspirin and ticlopidine as a post-stenting administration. A 77-year-old man had repeated stent thrombosis, which was not predicted by coronary angiography, despite using contemporary periprocedural anti-platelet therapy. Only intravascular fiberscopy was able to detect the cause of the stent thrombosis. (Jpn Circ J 2001; 65: 232 -235)

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Section: Discussionmentioning

confidence: 91%

Usefulness of Intracoronary Angioscopy for Elucidating the Cause of Subacute Thrombosis After Stenting

et al. 2001

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“…E) Ultra-som como método de monitoração de uma intervenção coronariana percutânea (stents) -O ultra-som é capaz de detectar alterações na luz do vaso, que, apesar de relativamente pequenas (em média de 0,5 mm), apresentam impacto clínico significativo. Essas alterações poderiam determinar condutas distintas, seja durante o implante, elevando a pressão de impactação da endoprótese na parede do vaso, aumentando o calibre do balão ou, quando da realização da cinecoronariografia tardia, auxiliando na decisão de revascularizar o vaso previamente tratado 50 .…”

Section: -Indicações Clínicas Do Ultra-som Intracoronarianounclassified

Diretriz de indicações do ultra-som intracoronariano na prática clínica

Costantine¹,

Mattos²,

Caixeta³

et al. 2003

Arq. Bras. Cardiol.

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“…[3][4][5][6] These features have been associated with death, reinfarction, or need for repeat revascularization when lesions were treated within 17 days of the index event (risk ratio of 6.6 to 10.15). 4, 5 The presence of angioscopically detected thrombus or ruptured plaque preceding coronary intervention is associated with an increased rate of restenosis (52% to 54%) as well as a higher incidence of total occlusion at follow-up (4% to 7%). 7 Van Belle et al 1 have now demonstrated that these unfavorable lesion features persist for at least 1 month after the index event in many patients.…”

Section: See P 26 Commentarymentioning

confidence: 99%

Pathophysiological Insight Into the Possible Optimal Therapies for Acute Myocardial Infarction and Unstable Angina

Smalling

Anderson

1998

Circulation

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T he optimal treatment of unstable ischemic coronary syndromes has not been settled, and little in vivo pathological information in humans has been available to help guide the care of patients with these complicated problems. Dr Van Belle and colleagues 1 have given us new insight into the underlying pathophysiological substrate in patients sustaining acute myocardial infarction who then underwent coronary angioscopy before coronary interventions up to 1 month after their index event. Of these patients, 98% were treated with aspirin, 66% had thrombolytic therapy, and 100% had been treated with heparin for at least 72 hours after admission. Despite this intense antithrombotic regimen, the residual lesions were angiographically severe in 76%, and complete occlusions were found in 14% of the patients. By angioscopy, the majority of the infarct-related lesions were yellow (79%), and many were ulcerated (36%) or had visible residual thrombus (77%). Eighteen percent of the patients had large clumps of platelets adherent to the plaque, even late in the course after infarction. The fact that these plaques remained "active" for up to 30 days is quite interesting and unsettling. There was an equal prevalence of yellow ulcerated plaques with thrombus, whether they were studied between 0 and 10 days or 10 and 30 days after admission. Furthermore, the use of thrombolytics seemed to promote an increased incidence of ulcerated plaques, and adherent thrombus, although smaller, was still present. Other investigators have suggested that mechanical restoration of infarct artery patency reduces both the incidence of "active" plaques and the presence of thrombus several days after intervention.

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Comparison of angioscopy, intravascular ultrasound imaging and quantitative coronary angiography in predicting clinical outcome after coronary intervention in high risk patients

Abstract: Angioscopic plaque rupture and thrombus were independently associated with adverse outcome in patients with complex lesions after interventional procedures. These features were not identified by either angiography or intravascular ultrasound.

Cited by 59 publications

References 34 publications

Usefulness of Intracoronary Angioscopy for Elucidating the Cause of Subacute Thrombosis After Stenting

Usefulness of Intracoronary Angioscopy for Elucidating the Cause of Subacute Thrombosis After Stenting

Diretriz de indicações do ultra-som intracoronariano na prática clínica

Pathophysiological Insight Into the Possible Optimal Therapies for Acute Myocardial Infarction and Unstable Angina

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