Plaque Tissue Components Obtained from De Novo Lesions may Predict Restenosis after Directional Coronary Atherectomy

Abstract

Background: A part of coronary stenotic lesions treated with directional coronary atherectomy (DCA) occur restenosis several months later. Specimens obtained by first DCA, present the histology of culplit lesions and may predict restenosis after PCI. Methods: The study group comprised 76 patients (male/female 65/11, age 61 ± 11 years). Restenosis, defined as > 50% stenosis diameter by quantitative cineangiography, was present in 26 patients. The other 50 patients (< 50% stenosis) constitute the " no restenosis" group. Inflammatory cells and other atheroma components were planimetrically quantified as a percentage of total tissue area. Results: As regards lymphocytes, neutrophils and smooth muscle cells, the grade of amount of cells did not differ between restenosis group and no restenosis group. The amount of obtained arterial media was similar, too. However, the area occupied by macrophages or calcified fragments was significantly larger in restenosis group than no restenosis group. And there was a tendency toward larger area occupied by cholesterol gruel, thrombus and myxomatous extracellular matrix (ECM) in restenosis group. Conclusion: Rich macrophages infiltration, calcified fragments, cholesterol rich gruel and myxomatous ECM from primary lesions can be predictors of restenosis after DCA, suggesting a possible role in restenotic process after PCI.

In-Vivo Higher Plasma Levels of Platelet-Derived Growth Factor and Matrix Metalloproteinase-9 in Coronary Artery at the Very Onset of Myocardial Infarction with ST-Segment Elevation

“…5) The lesion has some inflammatory cells, thrombus and myxomatous extracellular matrix. 6) The PDGF induce MMPs, including type IV collagenase (MMP-2 and MMP-9) in a variety of cell types, [7][8][9] and PDGF and tumor necrosis factor in combination can synergistically up-regulate MMP-9 in vascular smooth muscle cells.…”

Chlamydia pneumoniae is Prevalent in Symptomatic Coronary Atherosclerotic Plaque Samples Obtained From Directional Coronary Atherectomy, but its Quantity is Not Associated With Plaque Instability: An Immunohistochemical and Molecular Study

“…In addition, our study did not find an association between the extent of C. pneumoniae infection and the presence or absence of post-DCA restenosis. Post-DCA restenosis is a reactive process after a tissue loss that proceeds over months, 36 whereas atherosclerosis proceeds over decades. C. pneumoniae does not appear to contribute to the former.…”

Ultrasound-mediated delivery of Pik3cb shRNA using magnetic nanoparticles for the treatment of in-stent restenosis in a rat balloon-injured model

“…In recent decades, with the development of percutaneous transluminal coronary angioplasty (PTCA), which is widely used in the treatment of coronary heart diseases, the quality of life of patients has improved markedly, but 20–40% of patients still suffer from recurrent stent restenosis after PTCA [ 1 ]. In-stent restenosis (ISR) is a postoperative complication of intraluminal stenting.…”