The histological characteristics and virtual histology findings of the tissues obtained by a distal protection device during endovascular therapy for peripheral artery disease

Maezawa, Hideyuki; Maeda, Atsuo; Iso, Yoshitaka; Sakai, Tetsuo; Suzuki, Hiroshi

doi:10.1016/j.jjcc.2016.02.002

Cited by 6 publications

(6 citation statements)

References 25 publications

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“…Distal embolization is one of the most serious complications during endovascular procedures. The incidence of distal embolization following routine angioplasty and EVT in patients with PAD has been reported to range from 0.8% to 18.8%, depending on the series [9]. Maezawa et al reported that large debris, which was defined as debris of >2 mm in maximal diameter, was confirmed in 33 of 69 patients (48%) and was trapped more frequently in the iliac artery than in the femoral artery.…”

Section: Discussionmentioning

confidence: 99%

“…Maezawa et al reported that large debris, which was defined as debris of >2 mm in maximal diameter, was confirmed in 33 of 69 patients (48%) and was trapped more frequently in the iliac artery than in the femoral artery. They concluded that distal protection would be considered when the lesion is ulcerative, located in the iliac artery, and found to contain a necrotic core on virtual histology intravascular ultrasound [9]. On the other hand, in order to increase cost-effectiveness, it is not necessary to use protection devices in all cases.…”

Section: Discussionmentioning

confidence: 99%

“…Cholesterol crystal embolization (CCE) is one of the serious complications associated with endovascular therapy (EVT) for PAD. There is no established treatment for CCE other than supportive therapy [8], resulting in limb amputation [9]. Therefore, we believe that detecting vulnerable plaque before EVT for PAD will be helpful for predicting and preventing CCE.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Application of Magnetic Resonance Plaque Imaging Using Inversion-Recovery and Fat-Suppressed Three-Dimensional Steady-State Free Precession to Iliac Artery Stenosis

Sasaki

Kawasaki

Horinouchi

et al. 2018

Interventional Radiology

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A 61-year-old Japanese man with right common iliac artery stenosis underwent magnetic resonance plaque imaging for an evaluation of the nature of the stenosis that used inversion-recovery and fat-suppressed threedimensional steady-state free precession (IR-SSFP) and T1-weighted black blood imaging. The stenosis was depicted as diffuse high signal intensity on the IR-SSFP, and the deep layer was depicted as high signal intensity on the T1-weighted black blood image, suggesting a lipid-rich necrotic core in the shallow layer and intraplaque hemorrhage in the deep layer. After an evaluation by intravascular endoscopy and optical coherence tomography (OCT), stent placement was performed under balloon protection. Yellowish plaque was aspirated from a balloon guiding catheter, and a histopathological examination confirmed cholesterol crystals and a thrombus.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Application of Magnetic Resonance Plaque Imaging Using Inversion-Recovery and Fat-Suppressed Three-Dimensional Steady-State Free Precession to Iliac Artery Stenosis

Sasaki

Kawasaki

Horinouchi

et al. 2018

Interventional Radiology

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“…In a study on patients with PAD treated with endovascular therapy using a filter device to prevent distal embolization, histologic, immunohistochemical, and immunofluorescence analyses revealed the presence of inflammatory cells, mainly CD68-positive cells that were also positive for MPO, in nearly half of the debris particles [ 185 ]. Higher blood MPO levels have been reported in patients with PAD than in healthy subjects [ 144 , 186 ], although others have found opposite results [ 186 ].…”

Section: The Established Role Of Neutrophils In Peripheral Artery Dis...mentioning

confidence: 99%

The Role of Neutrophils in Lower Limb Peripheral Artery Disease: State of the Art and Future Perspectives

Buso

Faggin

Rosenblatt‐Velin

et al. 2023

IJMS

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In recent years, increasing attention has been paid to the role of neutrophils in cardiovascular (CV) disease (CVD) with evidence supporting their role in the initiation, progression, and rupture of atherosclerotic plaque. Although these cells have long been considered as terminally differentiated cells with a relatively limited spectrum of action, recent research has revealed intriguing novel cellular functions, including neutrophil extracellular trap (NET) generation and inflammasome activation, which have been linked to several human diseases, including CVD. While most research to date has focused on the role of neutrophils in coronary artery and cerebrovascular diseases, much less information is available on lower limb peripheral artery disease (PAD). PAD is a widespread condition associated with great morbidity and mortality, though physician and patient awareness of the disease remains low. To date, several studies have produced some evidence on the role of certain biomarkers of neutrophil activation in this clinical setting. However, the etiopathogenetic role of neutrophils, and in particular of some of the newly discovered mechanisms, has yet to be fully elucidated. In the future, complementary assessment of neutrophil activity should improve CV risk stratification and provide personalized treatments to patients with PAD. This review aims to summarize the basic principles and recent advances in the understanding of neutrophil biology, current knowledge about the role of neutrophils in atherosclerosis, as well as available evidence on their role of PAD.

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“…18) Recently, Maezawa et al reported that the necrotic core that was evaluated by VH-IVUS developed more frequently in the debris group than in the small debris group in the iliac and femoral arteries. 19) They concluded that distal protection during PTA would be considered when the lesion is an ulcerative and contained necrotic core that was determined by VH-IVUS. However, regarding the relationships between tissue components of the peripheral arteries and outcomes of PTA, further studies are needed.…”

Section: Tissue Characterization For Peripheral Arteriesmentioning

confidence: 99%

Development of Integrated Backscatter Intravascular Ultrasound for Tissue Characterization of Peripheral Artery and Comparison with Angioscopy

et al. 2016

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Background: The purpose of the present study was to determine the differences in integrated backscatter (IB) values between a new IB intravascular ultrasound (IB-IVUS) mode for peripheral artery and the previous mode for coronary arteries for the tissue characterization of plaques. Methods: A cross-validation study was performed with the 40 patients divided into a training study to determine the difference in IB value and the most appropriate correction for ultrasound signal attenuation between the mode for coronary and peripheral arteries (n = 20) and a testing study to validate the similarity of the images (n = 20). Comparison between the findings of IB-IVUS and angioscopy was performed in 10 patients. Results: In the training study, 57 cross sections were subjected to the comparison. The IB value of +4.5 dB was the most appropriate setting compared with the mode for coronary arteries. The slope of regression lines were 1.00 in the measurement of lipid area and 1.00 in the measurement of fibrous area. The most appropriate correlation for ultrasound signal attenuation was +3.0 dB/mm. In the testing study, the slopes of regression lines in the measurement of lipid and fibrous areas were excellent in 20 cross sections (1.00 and 1.02, respectively) based on the settings that were determined in the training study. In the comparison with angioscopy, thickness of fibrous cap was associated with the color of plaques in peripheral arteries. Conclusions: The IB-IVUS system with the new mode for peripheral arteries provides high diagnostic accuracy for the analysis of tissue characteristics of plaques.

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The histological characteristics and virtual histology findings of the tissues obtained by a distal protection device during endovascular therapy for peripheral artery disease

Cited by 6 publications

References 25 publications

Application of Magnetic Resonance Plaque Imaging Using Inversion-Recovery and Fat-Suppressed Three-Dimensional Steady-State Free Precession to Iliac Artery Stenosis

Application of Magnetic Resonance Plaque Imaging Using Inversion-Recovery and Fat-Suppressed Three-Dimensional Steady-State Free Precession to Iliac Artery Stenosis

The Role of Neutrophils in Lower Limb Peripheral Artery Disease: State of the Art and Future Perspectives

Development of Integrated Backscatter Intravascular Ultrasound for Tissue Characterization of Peripheral Artery and Comparison with Angioscopy

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