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Assessment of plaque evolution in coronary bifurcations located beyond everolimus eluting scaffolds: serial intravascular ultrasound virtual histology study.

Lee IS, Bourantas CV, Muramatsu T, Gogas BD, Heo JH, Diletti R, Farooq V, Zhang Y, Onuma Y, Serruys PW, Garcia-Garcia HM - Cardiovasc Ultrasound (2013)

Bottom Line: There were no significant differences in the geometrical parameters such as lumen, vessel and plaque areas as well as in the composition of the atheroma between baseline and 2-years follow-up.When we separately examined the bifurcations located proximally and distally to the scaffolded segment, no changes were found at the distal bifurcations, while at the proximal bifurcations there was a statistical significant decrease in the plaque burden (36.67 ± 13.33% at baseline vs. 35.06 ± 13.20% at 2 years follow-up, p = 0.04).Ten necrotic core rich plaques were found at baseline, of which 2 regressed to either fibrotic plaque or to intimal thickening at 2 years follow-up.The other 8 did not change.Additional studies are required to confirm this finding and examine further the effect of drug elution on atherosclerotic evolution.

View Article: PubMed Central - HTML - PubMed

Affiliation: Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands.

ABSTRACT

Purpose: To evaluate the atherosclerotic evolution in coronary bifurcations located proximally and distally to a bioresorbable scaffold.

Methods: Thirty bifurcations located >5 mm beyond the scaffolded segment, being investigated with serial intravascular ultrasound virtual histology (IVUS-VH) examinations, at baseline and 2-years, in patients enrolled in the ABSORB cohort B1 study were included in this analysis. In each bifurcation, the frames portraying the proximal rim, in-bifurcation, and distal rim of the ostium of the side branch were analyzed. The geometric parameters and plaque types were evaluated at baseline and 2-years follow-up.

Results: There were no significant differences in the geometrical parameters such as lumen, vessel and plaque areas as well as in the composition of the atheroma between baseline and 2-years follow-up.When we separately examined the bifurcations located proximally and distally to the scaffolded segment, no changes were found at the distal bifurcations, while at the proximal bifurcations there was a statistical significant decrease in the plaque burden (36.67 ± 13.33% at baseline vs. 35.06 ± 13.20% at 2 years follow-up, p = 0.04).Ten necrotic core rich plaques were found at baseline, of which 2 regressed to either fibrotic plaque or to intimal thickening at 2 years follow-up. The other 8 did not change. Disease progression was noted in 3 plaques (1 adaptive intimal thickening, 1 fibrotic and 1 fibrocalcific plaque) that evolved to necrotic rich plaques.

Conclusions: Plaque regression was noted at the bifurcations located proximally to the bioresorbable scaffold but not at these located distally. Additional studies are required to confirm this finding and examine further the effect of drug elution on atherosclerotic evolution.

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Related in: MedlinePlus

Changes in type of the plaque type detected at the coronary bifurcations. For each plaque type, the percent of changes is reported. AIT, adaptive intimal thickening; CaFA, calcified fibroatheroma; CaTCFA, calcified thin-cap fibroatheroma; FA, fibroatheroma; FC, fibrocalcific plaque; FT, fibrotic plaque; PIT, pathologic intimal thickening; TCFA, thin-cap fibroatheroma.
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Figure 5: Changes in type of the plaque type detected at the coronary bifurcations. For each plaque type, the percent of changes is reported. AIT, adaptive intimal thickening; CaFA, calcified fibroatheroma; CaTCFA, calcified thin-cap fibroatheroma; FA, fibroatheroma; FC, fibrocalcific plaque; FT, fibrotic plaque; PIT, pathologic intimal thickening; TCFA, thin-cap fibroatheroma.

Mentions: At baseline, 10 NC-rich plaques were found, 4 of which were classified as thin-cap lesions (1 TCFA and 3 calcified TCFA) (Figure 5). One fibroatheroma became pathological intimal thickening and another calcified fibroatheroma became fibrotic plaque suggesting disease regression in these plaques. On the other hand 3 new NC-rich lesions developed from 1 adaptive intimal thickening, 1 fibrotic and 1 fibrocalcific plaques implying disease progression. Eight NC-rich plaques (80%) did not change at follow-up. Most of the thin-cap lesions (n = 3, 75%) were also unchanged apart from 1 calcified TCFA that became calcified fibroatheroma.


Assessment of plaque evolution in coronary bifurcations located beyond everolimus eluting scaffolds: serial intravascular ultrasound virtual histology study.

Lee IS, Bourantas CV, Muramatsu T, Gogas BD, Heo JH, Diletti R, Farooq V, Zhang Y, Onuma Y, Serruys PW, Garcia-Garcia HM - Cardiovasc Ultrasound (2013)

Changes in type of the plaque type detected at the coronary bifurcations. For each plaque type, the percent of changes is reported. AIT, adaptive intimal thickening; CaFA, calcified fibroatheroma; CaTCFA, calcified thin-cap fibroatheroma; FA, fibroatheroma; FC, fibrocalcific plaque; FT, fibrotic plaque; PIT, pathologic intimal thickening; TCFA, thin-cap fibroatheroma.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3722121&req=5

Figure 5: Changes in type of the plaque type detected at the coronary bifurcations. For each plaque type, the percent of changes is reported. AIT, adaptive intimal thickening; CaFA, calcified fibroatheroma; CaTCFA, calcified thin-cap fibroatheroma; FA, fibroatheroma; FC, fibrocalcific plaque; FT, fibrotic plaque; PIT, pathologic intimal thickening; TCFA, thin-cap fibroatheroma.
Mentions: At baseline, 10 NC-rich plaques were found, 4 of which were classified as thin-cap lesions (1 TCFA and 3 calcified TCFA) (Figure 5). One fibroatheroma became pathological intimal thickening and another calcified fibroatheroma became fibrotic plaque suggesting disease regression in these plaques. On the other hand 3 new NC-rich lesions developed from 1 adaptive intimal thickening, 1 fibrotic and 1 fibrocalcific plaques implying disease progression. Eight NC-rich plaques (80%) did not change at follow-up. Most of the thin-cap lesions (n = 3, 75%) were also unchanged apart from 1 calcified TCFA that became calcified fibroatheroma.

Bottom Line: There were no significant differences in the geometrical parameters such as lumen, vessel and plaque areas as well as in the composition of the atheroma between baseline and 2-years follow-up.When we separately examined the bifurcations located proximally and distally to the scaffolded segment, no changes were found at the distal bifurcations, while at the proximal bifurcations there was a statistical significant decrease in the plaque burden (36.67 ± 13.33% at baseline vs. 35.06 ± 13.20% at 2 years follow-up, p = 0.04).Ten necrotic core rich plaques were found at baseline, of which 2 regressed to either fibrotic plaque or to intimal thickening at 2 years follow-up.The other 8 did not change.Additional studies are required to confirm this finding and examine further the effect of drug elution on atherosclerotic evolution.

View Article: PubMed Central - HTML - PubMed

Affiliation: Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands.

ABSTRACT

Purpose: To evaluate the atherosclerotic evolution in coronary bifurcations located proximally and distally to a bioresorbable scaffold.

Methods: Thirty bifurcations located >5 mm beyond the scaffolded segment, being investigated with serial intravascular ultrasound virtual histology (IVUS-VH) examinations, at baseline and 2-years, in patients enrolled in the ABSORB cohort B1 study were included in this analysis. In each bifurcation, the frames portraying the proximal rim, in-bifurcation, and distal rim of the ostium of the side branch were analyzed. The geometric parameters and plaque types were evaluated at baseline and 2-years follow-up.

Results: There were no significant differences in the geometrical parameters such as lumen, vessel and plaque areas as well as in the composition of the atheroma between baseline and 2-years follow-up.When we separately examined the bifurcations located proximally and distally to the scaffolded segment, no changes were found at the distal bifurcations, while at the proximal bifurcations there was a statistical significant decrease in the plaque burden (36.67 ± 13.33% at baseline vs. 35.06 ± 13.20% at 2 years follow-up, p = 0.04).Ten necrotic core rich plaques were found at baseline, of which 2 regressed to either fibrotic plaque or to intimal thickening at 2 years follow-up. The other 8 did not change. Disease progression was noted in 3 plaques (1 adaptive intimal thickening, 1 fibrotic and 1 fibrocalcific plaque) that evolved to necrotic rich plaques.

Conclusions: Plaque regression was noted at the bifurcations located proximally to the bioresorbable scaffold but not at these located distally. Additional studies are required to confirm this finding and examine further the effect of drug elution on atherosclerotic evolution.

Show MeSH
Related in: MedlinePlus