Impact of arterial remodelling and plaque rupture on target and non-target lesion revascularisation after stent implantation in patients with acute coronary syndrome: an intravascular ultrasound study

Okura, Hiroyuki; Taguchi, Haruyuki; Kubo, Tomoichiro; Toda, Iku; Yoshiyama, Minoru; Yoshikawa, Junichi; Yoshida, Kiyoshi

doi:10.1136/hrt.2006.096370

Cited by 17 publications

(13 citation statements)

References 30 publications

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“…This is quite in concordance with previous coronary IVUS studies. 8,18 However, this result should be carefully interpreted. The difference mainly comes from the higher incidence of unplanned vascular interventions because of nontarget lesion progres- sion or target lesion restenosis in patients with plaque rupture in the iliofemoral arteries than in patients without plaque rupture.…”

Section: Okura Et Al Plaque Rupture In Peripheral Artery Diseasementioning

confidence: 99%

“…3 Plaque rupture was defined as the presence of a cavity that communicated with the lumen with an overlying residual fibrous cap fragment. 3,18 IVUS measurements were performed at the narrowest cross-sections in the target segment. IVUS measurements were also performed at the nonsignificant or nontarget cross-sections with plaque rupture in the iliofemoral arteries.…”

Section: Qualitative and Quantitative Ivus Analysesmentioning

confidence: 99%

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Incidence and Predictors of Plaque Rupture in the Peripheral Arteries

Okura

Asawa

Kubo

et al. 2010

Circ: Cardiovascular Interventions

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Background-Plaque rupture may be present in the peripheral arteries of the patients at high risk for cardiovascular events and is possibly associated with vascular vulnerability. Methods and Results-One hundred one iliofemoral arteries from 101 patients undergoing angioplasty were studied.Intravascular ultrasound imaging was performed before intervention. Plaque rupture was defined as presence of a cavity that communicated with the lumen with an overlying residual fibrous cap fragment. Incidence, numbers, and location of the plaque rupture were investigated. Plaque rupture was found in 42 of 101 arteries (42%). Patients with plaque rupture had significantly higher prevalence of acute coronary syndrome than did patients without plaque rupture (42% vs 16%, Pϭ0.01). By multivariable logistic regression analysis, acute coronary syndrome (Pϭ0.004) and male sex (Pϭ0.01) were independent clinical correlates of plaque rupture. During follow-up (median, 14.7 months), the incidence of major adverse cardiac or cerebrovascular events (death, myocardial infarction, and ischemic stroke) was similar between the 2 groups. The incidence of major adverse cardiac or cerebrovascular events plus peripheral vascular events (unplanned vascular intervention and amputation) was significantly higher in patients with plaque rupture than in patients without plaque rupture (46% vs 21%, Pϭ0.008). By multivariable Cox regression analysis, plaque rupture (hazard ratioϭ2.80, 95% CI: 1.23 to 6.37, Pϭ0.01) and Fontaine stage IV (hazard ratioϭ3.50, 95% CI: 1.58 to 7.71, Pϭ0.002) were independent predictors of major adverse cardiac or cerebrovascular events plus peripheral vascular events. Conclusions-Ruptured plaque of the iliofemoral arteries is a common finding. Patients with plaque rupture had a higher prevalence of history of acute coronary syndrome and lower major adverse cardiac or cerebrovascular events plus peripheral vascular event-free survival. (Circ Cardiovasc Interv. 2010;3:63-70.)

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Section: Okura Et Al Plaque Rupture In Peripheral Artery Diseasementioning

confidence: 99%

Section: Qualitative and Quantitative Ivus Analysesmentioning

confidence: 99%

Incidence and Predictors of Plaque Rupture in the Peripheral Arteries

Okura

Asawa

Kubo

et al. 2010

Circ: Cardiovascular Interventions

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“…[5][6][7]28,35,36 Furthermore, previous IVUS studies have consistently demonstrated that lesions with positive remodeling were associated with worse clinical outcomes. 15,19,36 -40 In our present study population, 12-month clinical follow-up did not show any prognostic impact of the arterial and fibrous cap remodeling because of the small sample size and short follow-up period.…”

Section: Discussionmentioning

confidence: 99%

Relationship Between Arterial and Fibrous Cap Remodeling

Yamada

Okura

Kume

et al. 2010

Circ: Cardiovascular Interventions

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Background-Positive arterial remodeling and thin fibrous cap are characteristics of rupture-prone or vulnerable plaque.The natural course of the fibrous cap thickness and the relationship between serial arterial remodeling and changes in fibrous cap thickness are unknown. Therefore, the purpose of this study was to evaluate the relationship between changes in fibrous cap thickness and arterial remodeling by using optical coherence tomography (OCT) and intravascular ultrasound (IVUS) during 6-month follow-up. Methods and Results-Both IVUS and OCT examinations were performed on 108 vessels from 36 patients with ischemic heart disease who underwent percutaneous coronary intervention. Fifty-eight fibroatheromas were selected from 82 nonsignificant, nonculprit lesions (angiographic diameter stenosis, 25% to 75%; plaque burden, Ͼ40% by IVUS

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“…Indeed, Schoenhagen et al cations. Moreover, in a study in 137 patients who presented with acute coronary syndromes, the presence of expansively remodeled lesions before stenting was predictive for the occurrence of cardiac events and lesion revascularization at 2 years (9). On the other hand, however, in the same aforementioned substudy of the REVERSAL trial it was also shown that the mode of arterial remodeling (expansive or constrictive) was not related to a change in atheroma volume comparing serial ultrasound data at baseline and follow-up (10), suggesting that the mode of geometrical remodeling cannot serve as an alternative surrogate measure for plaque progression over time.…”

Section: See Page 1708mentioning

confidence: 98%