Evaluation of plaque composition by intravascular ultrasound “virtual histology”: the impact of dense calcium on the measurement of necrotic tissue

Sales, Fernando José Ribeiro; Falcão, Breno de Alencar Araripe; Falcão, J. L. A. A.; Ribeiro, Expedito E.; Perin, Marco Antônio; Horta, Pedro; Spadaro, André Gasparini; Ambrose, John A.; Martinez, Eulógio E.; Furuie, S.S.; Lemos, Pedro A.

doi:10.4244/eijv6i3a65

Cited by 33 publications

(26 citation statements)

References 10 publications

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“…While VH-IVUS provides a color-coded map of the atherosclerotic plaque components, including fibrous (dark green), fatty (yellow/light-green), white (calcified), and red (necrotic LCP) components, the accuracy of VH-IVUS is limited in the presence of heavy calcification. 13,14 A positive relationship has been shown between VH-derived % necrotic core plaque and NIRS-derived LCBI in non-calcified plaques, but not in calcified plaques. 15 OCT is much less practical for imaging long segments of SFA disease because of limited penetration depth and the need for large volumes of contrast.…”

Section: Currently Available Intravascular Imaging Techniques Includementioning

confidence: 99%

Invasive evaluation of plaque morphology of symptomatic superficial femoral artery stenoses using combined near-infrared spectroscopy and intravascular ultrasound

et al. 2016

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The purpose of this study is to characterize the plaque morphology of severe stenoses in the superficial femoral artery (SFA) employing combined near-infrared spectroscopy and intravascular ultrasound (NIRS-IVUS). Atherosclerosis is the most common cause of symptomatic peripheral arterial disease. Plaque composition of SFA stenoses has been characterized as primarily fibrous or fibrocalcific by non-invasive and autopsy studies. NIRS has been validated to detect lipid-core plaque (LCP) in the coronary circulation. We imaged severe SFA stenoses with NIRS-IVUS prior to revascularization in 31 patients (46 stenoses) with Rutherford claudication ⩾ class 3. Angiographic parameters included lesion location and stenosis severity. IVUS parameters included plaque burden and presence of calcium. NIRS images were analyzed for LCP and maximum lipid-core burden index in a 4-mm length of artery (maxLCBI 4mm ). By angiography, 38 (82.6%) lesions were calcified and 9 (19.6%) were chronic total occlusions. Baseline stenosis severity and lesion length were 86.0 ± 11.0% and 36.5 ± 46.5 mm, respectively. NIRS-IVUS identified calcium in 45 (97.8%) lesions and LCP in 17 (37.0%) lesions. MaxLCBI 4mm was 433 ± 244. All lesions with LCP also contained calcium; there were no noncalcified lesions with LCP. In conclusion, this is the first study of combined NIRS-IVUS in patients with PAD. NIRS-IVUS demonstrates that nearly all patients with symptomatic severe SFA disease have fibrocalcific plaque, and one-third of such lesions contain LCP. These findings contrast with those in patients with acute coronary syndromes, and may have implications regarding the pathophysiology of atherosclerosis in different vascular beds.

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Section: Currently Available Intravascular Imaging Techniques Includementioning

confidence: 99%

Invasive evaluation of plaque morphology of symptomatic superficial femoral artery stenoses using combined near-infrared spectroscopy and intravascular ultrasound

et al. 2016

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“…Estos resultados se explican por la falta de sensibilidad y especificidad del IVUS y la HV para identificar placas realmente vulnerables, porque no pueden diferenciar entre fibroateromas con cápsula gruesa o fina 20 . Además, se ha puesto en entredicho la capacidad de la HV para detectar el core necrótico 21 . La gran precisión de la OCT para medir el grosor de la cápsula fibrosa la convierten en la mejor técnica de imagen intravascular para detectar placas vulnerables 22,23 .…”

Section: Resultsunclassified

Patients with vulnerable coronary plaques have higher serum metalloproteinase-1 levels

Elvira

Coma-Canella

Artaiz

et al. 2017

An Sist Sanit Navar

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Fundamento. Las placas ateroscleróticas que producen la mayoría de los síndromes coronarios agudos al romperse son los fibroateromas de cápsula fina, denominados placas vulnerables. Éstas pueden ser detectadas únicamente con técnicas invasivas de imagen intracoronaria. Es preciso encontrar un biomarcador no invasivo que permita identificar a los pacientes con estas placas sin necesidad de cateterismo cardiaco. La metaloproteinasa-1 es una enzima involucrada en el metabolismo de la matriz extracelular que ha sido relacionada con la ruptura de las placas ateroscleróticas. Se desconocen sus niveles séricos en pacientes con placas vulnerables. Material y métodos.Se incluyeron pacientes sometidos a cateterismo cardiaco por enfermedad coronaria estable. Se estudiaron las arterias coronarias con tomografía de coherencia óptica para detectar placas vulnerables. Se extrajeron muestras de sangre periférica y del seno coronario para analizar la concentración de metaloproteinasa-1.resultados. Se incluyeron 51 pacientes. Trece tenían al menos un fibroateroma de cápsula fina. No se encontraron diferencias significativas en las características clínicas, perfil lipídico ni proteína C reactiva entre los pacientes con y sin placas vulnerables. Los pacientes con placas vulnerables presentaron concentraciones significativamente mayores de metaloproteinasa-1, tanto en sangre periférica (7330±5541 vs 2894±1783 pg/ml, p=0,025) como en seno coronario (6012±3854 vs 2707±1252 pg/ml, p=0,047).conclusiones. Los pacientes con placas vulnerables presentaron niveles séricos significativamente mayores de metaloproteinasa-1. Se requieren estudios con seguimiento clínico para evaluar el valor pronóstico de la metaloproteinasa-1 sérica.Palabras clave: Placa vulnerable. Fibroateroma de cápsula fina. Biomarcador. Metaloproteinasa-1. Síndrome coronario agudo.

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“…However, we found no correlation between plaque size and change in hyperechogenicity at the various time points. IVUS-virtual histology could be used to evaluate the characteristics of the scaffolded plaque: the overestimation of virtual histology-dense calcium and necrotic core after ABSORB implantation precludes this kind of analysis (30,31).…”

Section: Discussionmentioning

confidence: 99%

Serial In Vivo Intravascular Ultrasound-Based Echogenicity Changes of Everolimus-Eluting Bioresorbable Vascular Scaffold During the First 12 Months After Implantation

Brugaletta

Gomez‐Lara

Serruys

et al. 2011

JACC: Cardiovascular Interventions

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Evaluation of plaque composition by intravascular ultrasound “virtual histology”: the impact of dense calcium on the measurement of necrotic tissue

Cited by 33 publications

References 10 publications

Invasive evaluation of plaque morphology of symptomatic superficial femoral artery stenoses using combined near-infrared spectroscopy and intravascular ultrasound

Invasive evaluation of plaque morphology of symptomatic superficial femoral artery stenoses using combined near-infrared spectroscopy and intravascular ultrasound

Patients with vulnerable coronary plaques have higher serum metalloproteinase-1 levels

Serial In Vivo Intravascular Ultrasound-Based Echogenicity Changes of Everolimus-Eluting Bioresorbable Vascular Scaffold During the First 12 Months After Implantation

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