The correlation between lipid volume in the target lesion, measured by integrated backscatter intravascular ultrasound, and post-procedural myocardial infarction in patients with elective stent implantation

Abstract

A larger plaque volume and lipid-rich plaque may be indicative of embolic events after stent implantation, resulting in myocardial injury.

Intense Yellow Culprit Plaque Coloration is Closely Associated with Troponin-T Elevation and Flow Complications Following Elective Coronary Stenting

“…The proportion of post-procedural myocardial injury was higher than in the previous report, accounting for 11% 9) . The cut-off value of TnT in the previous study was 0.3 ng/mL, and different definitions of post-procedural myocardial injury may explain these discrepancies.…”

“…A recent study showed that a larger volume and lipid-rich plaque on IB-IVUS might be indicative of post-procedural myocardial injury in elective PCI 9) . Intense yellow plaques upon angioscopic examination correlated with the presence of a plaque with a large lipid area on IB-IVUS display 14) .…”

“…As a result, mural thrombi are not considered to likely be either a powerful predictor or to have the ability to induce post-procedural myocardial injury in cases of In this study, the frequency of pre-dilatation, maximum pressure inflation and the total inflation time were not found to influence post-procedural myocardial injury, while the total stent length was associated with post-procedural myocardial injury. Large plaque burden is a powerful predictor of postprocedural myocardial injury according to volumetric analysis using IVUS 9) . Combination study with angioscopy and gray-scale IVUS showed that the presence of yellow plaques is correlated with positive remodeling of coronary arteries 22) .…”

“…The elevation in TnT is indicative of myocardial injury resulting from a distal embolism or from microvascular obstruction by fragmented thrombi and plaque materials, which can cause no reflow or slow-flow phenomena during PCI 8) . A recent integrated-backscatter intravascular ultrasound (IB-IVUS) study demonstrated that lipid-rich plaques affected post-procedural myocardial injury in patients with stable angina 9) . Although we hypothesized that lesion characteristics, including thrombus, may be predictive factors of embolic complications, the identification of intracoronary thrombus with IB-IVUS is more difficult than with either coronary angioscopy or optical coherence tomography (OCT) 10) .…”

Decrease in lipid rich plaque during percutaneous coronary intervention: reality or artefact? An observational study using Near-Infrared Spectroscopy

“…These complications may include plaque shift and distal embolization of plaque debris, which could impair clinical outcomes [6]. There is emerging evidence that the reduction of the lipid content of LRPs is associated with the occurrence of distal embolization [7][8][9][10].…”