Usefulness of Virtual Histology Intravascular Ultrasound to Predict Distal Embolization for ST-Segment Elevation Myocardial Infarction

Abstract

Virtual Histology IVUS is a useful means of predicting the risk of distal embolization after primary stent deployment in patients with STEMI.

Intravascular ultrasound appearance of scattered necrotic core as an index for deterioration of coronary flow during intervention in acute coronary syndrome

“…From the pathologic classification, an organized thrombus shows ingrown smooth muscle cells with or without depositions of connective tissue and capillary vessel growth, which is similar to fibrous plaque. Thus, because an organized thrombus could often have been included in the analysis area of VH-IVUS in this study, plaque composition of a target lesion obtained by VH-IVUS was in contradiction with histopathological data, with more fibrous tissue volume that could result in a lower percentage necrotic core volume in the coronary flow deterioration group compared with previous reports 15,20 . From these findings, it is possible that the difference between the various findings using VH-IVUS is a reflection of the presence of a thrombus and its relative age.…”

“…Recent VH-IVUS studies have demonstrated that, as a qualitative assessment, necrotic core component and necrotic core volume predict the risk of distal embolization after primary stent deployment in patients with ST-segment elevation myocardial infarction 15 . Bae et al reported that fibrofatty volume was the only independent factor for slow flow during PCI in AMI patients 16 .…”

Thrombus Aspiration Therapy and Coronary Thrombus Components in Patients with Acute ST-Elevation Myocardial Infarction

“…Plaque volume and composition, particularly the necrotic core volume, has been shown to be associated with DE in patients with STEMI 85,86) . The presence symptom onset.…”

IVUS in the Assessment of Coronary Allograft Vasculopathy

“…(Figure 3) This approach has not been validated with histological techniques in heart transplant patients, however in the non-transplant population the overall predictive accuracies were 90.4% for fibrous tissue, 92.8% for fibrolipidic, 89.5% necrotic core, and 90.9% for dense calcium (Nair et al, 2001), (Nair et al, 2002), (Nasu et al, 2006). In native coronaries morphological composition of atherosclerotic plaque is a useful determinant of the plaque vulnerability (Ehara et al, 2004), (Naghavi et al, 2003), (Valgimigli et al, 2007), and identified plaques with a high-risk of future clinical events (Bae et al, 2008), (Kawaguchi et al, 2007), (Kawamoto et al, 2007). After heart transplantation, simultaneous assessment of virtual histology with IVUS provides detailed information about plaque morphology and composition, may improve the risk stratification of heart transplant recipients (Konig et al, 2008) and add important information in the clinical evaluation of heart transplant recipients (Raichlin et al, 2009).…”