The relationship between segmental wall shear stress and lipid core plaque derived from near-infrared spectroscopy

Shishikura, Daisuke; Sidharta, S.; Honda, Satoshi; Takata, Kohei; Kim, Susan W.; Andrews, Jordan; Montarello, Natalie; Delacroix, Sinny; Baillie, T.; Worthley, M.; Psaltis, Peter J.; Nicholls, Stephen J.

doi:10.1016/j.atherosclerosis.2018.04.022

Cited by 20 publications

(14 citation statements)

References 26 publications

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“… 12–16 Recently, a similar finding has also been described in a prospective study using the NIRS-IVUS catheter in the coronary arteries. 17 Here the authors found an association between the magnitude of baseline ESS and the progression of LCBI leading to the development of lipid-rich plaque at follow-up. 17 We hypothesize, based on these findings, that our observations can be explained by the distribution of ESS in the carotid AP.…”

Section: Discussionmentioning

confidence: 72%

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Carotid artery plaque composition and distribution: near-infrared spectroscopy and intravascular ultrasound analysis

Horváth

Hájek

Štěchovský

et al. 2020

European Heart Journal Supplements

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Most atherosclerotic plaques (APs) form in typical predilection areas of low endothelial shear stress (ESS). On the contrary, previous data hinted that plaques rupture in their proximal parts where accelerated blood flow causes high ESS. It was postulated that high ESS plays an important role in the latter stages of AP formation and in its destabilization. Here, we used near-infrared spectroscopy (NIRS) to analyse the distribution of lipid core based on the presumed exposure to ESS. A total of 117 carotid arteries were evaluated using NIRS and intravascular ultrasound (IVUS) prior to carotid artery stenting. The point of minimal luminal area (MLA) was determined using IVUS. A stepwise analysis of the presence of lipid core was then performed using NIRS. The lipid core presence was quantified as the lipid core burden index (LCBI) within 2 mm wide segments both proximally and distally to the MLA. The analysed vessel was then divided into three 20 mm long thirds (proximal, middle, and distal) for further analysis. The maximal value of LCBI (231.9 ± 245.7) was noted in the segment localized just 2 mm proximally to MLA. The mean LCBI in the middle third was significantly higher than both the proximal (121.4 ± 185.6 vs. 47.0 ± 96.5, P < 0.01) and distal regions (121.4 ± 185.6 vs. 32.4 ± 89.6, P < 0.01). Lipid core was more common in the proximal region when compared with the distal region (mean LCBI 47.0 ± 96.5 vs. 32.4 ± 89.6, P < 0.01).

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Section: Discussionmentioning

confidence: 72%

“… 12–16 Recently, a study proved an association between the magnitude of ESS and the progression of coronary AP lipid content as detected by near-infrared spectroscopy (NIRS). 17 We thus decided to perform a NIRS analysis of the lipid core distribution in carotid artery plaques based on the presumed exposure to ESS.…”

Section: Introductionmentioning

confidence: 99%

Carotid artery plaque composition and distribution: near-infrared spectroscopy and intravascular ultrasound analysis

Horváth

Hájek

Štěchovský

et al. 2020

European Heart Journal Supplements

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“…Also, in large arteries, the shear stress resulting from blood flow and circumferential stress resulting from the blood pressure acts on walls of the blood vessel [56]; thus, guidewire delivery interacted with the receptors present in the vascular, the guidewire tip overcame the friction force and moved [57], this force which depend on fluid velocity and blood pressure values [57], [58]. Value of Wall shear stress reflected the stage of disease, with low value a factor in early plaque formation and high value promoting transformation of plaque to a high-risk phenotype [59], [60], this complex environment required operators' highly technical skills to manipulate their hand as accurately and quickly as possible for guidewire reaching or passing the part of blood vessel with the plaque or stenosis [61]. In fact, the force in vascular model with plaque or stenosis and in smooth without plaque or stenosis presented in this study explains higher force value and specifically technical skills of operators necessary for a complex activity.…”

Section: Discussionmentioning

confidence: 99%

Exploration of Interventionists’ Technical Manipulation Skills for Robot-Assisted Intravascular PCI Catheterization

Omisore

Duan

et al. 2020

IEEE Access

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Despite the great proven advantages of imaging techniques in percutaneous coronary interventions (PCIs), the recent rapid increase in the number of PCI procedures exposes both surgical experts and patients to more radiation and orthopedic hazards in the intervention room. While patients are minimally exposed, many appearance of interventionists subject them to frequent exposure of the operational hazards. Despite promoting the use of robot-assisted intravascular PCI in the Cath-Labs, cognitive and technical skills of interventionists' are yet to be explored towards reducing procedure time and minimal exposure of surgeon to operational hazards. In this study, a random forest classification framework is developed for proper identification of technical manipulation skills of surgeons along with underlying motion patterns of the flexible intravascular tools (viz. guidewire and catheter) during PCI catheterization. For this purpose, analysis of interventionists' muscular activities and related hand motion were decoded from physiological signals recorded with sensors. Surface electromyography, electromagnetic, and tactile force signals were acquired concurrently from seven interventionists during specified guidewire movement viz. pull, push, rotate-pull (clockwise rotation with pull), rotate-push (counterclockwise rotation with push), CR (clockwise rotation), and CCR (counterclockwise rotation). While relations were established between force and muscle activities in the surgeon groups using Spearman's Rank-Order statistical method, Wilcoxon test and Kruskal-Wallis one-way ANOVA test were employed to identify intra-group and inter-group differences. From the experimental results obtained, guidewire delivery patterns exhibit stable characteristics with overall classification accuracies of 94.11% based on nineteen features subset from muscle activities and hand motion, followed by 88.01% based on twelve features subset from muscle activities, 71.97% based on seven features subset from hand motion, 84.56% based on ten features subset from part muscle activities and hand motion. Thus, this study shows existence of significant correlation (p < 0.05) between force and muscle activity during intravascular catheterization for PCIs, while comparably high tactile force values were experience in vascular model with plaque or stenosis.

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“…Previous studies have reported that high WSS is closely related to more vulnerable plaque [ 17 ]. High WSS assessed by intravascular ultrasound images is also associated with longitudinal development of high-risk plaque, including intraplaque necrotic core or expansive remodeling [ 15 , 18 , 19 ].…”

Section: Discussionmentioning

confidence: 99%

Balloon Deflation Strategy during Primary Percutaneous Coronary Intervention in Acute ST-Segment Elevation Myocardial Infarction: A Randomized Controlled Clinical Trial and Numerical Simulation-Based Analysis

Yang

Liu

et al. 2020

Cardiology Research and Practice

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Background. Primary percutaneous coronary intervention (PCI) is the best available reperfusion strategy in patients with acute ST-segment elevation myocardial infarction (STEMI). However, PCI is associated with a serious problem known as no-reflow phenomenon, resulting in poor clinical and functional outcomes. This study aimed to compare the influences of different balloon deflation velocity on coronary flow and cardiovascular events during primary PCI in STEM as well as transient hemodynamic changes in in vitro experiments. Method and Results. 211 STEMI patients were randomly assigned to either a rapid or a slow balloon deflation group during stent deployment. The primary end point was coronary flow at the end of PCI procedure, and secondary end points included myocardial infarct size. Transient hemodynamic changes were evaluated through an in vitro experimental apparatus and a computer model. In clinical practice, the level of corrected TIMI frame count (cTFC) in slow balloon deflation after primary PCI was significantly lower than that of rapid balloon deflation, which was associated with smaller infarct size. Numerical simulations revealed that the rapid deflation led to a sharp acceleration of flow in the balloon-vessel gap and a concomitant abnormal rise in wall shear stress (WSS). Conclusion. This randomized study demonstrated that the slow balloon deflation during stent implantation improved coronary flow and reduced infarct size in reperfused STEMI. The change of flow in the balloon-vessel gap and WSS resulted from different balloon deflation velocity might be partly accounted for this results.

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The relationship between segmental wall shear stress and lipid core plaque derived from near-infrared spectroscopy

Cited by 20 publications

References 26 publications

Carotid artery plaque composition and distribution: near-infrared spectroscopy and intravascular ultrasound analysis

Carotid artery plaque composition and distribution: near-infrared spectroscopy and intravascular ultrasound analysis

Exploration of Interventionists’ Technical Manipulation Skills for Robot-Assisted Intravascular PCI Catheterization

Balloon Deflation Strategy during Primary Percutaneous Coronary Intervention in Acute ST-Segment Elevation Myocardial Infarction: A Randomized Controlled Clinical Trial and Numerical Simulation-Based Analysis

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