| In-stent restenotic lesions can rupture-A case against plaque sealing. | |
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MedLine Citation:
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PMID: 20853362 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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We present a case of plaque rupture located inside a restenotic stent. Intravascular ultrasound defined a lesion with a minimal lumen area (MLA) of 3.59 cm(2) , plaque burden of 72%, and reference vessel luminal diameter of 4.0 mm with an external elastic membrane lumen cross-section area of 12.6 mm(2) . There was a clearly identified plaque rupture, with a flap-like dissection within the stented segment. Virtual histology intravascular ultrasound confirmed that the adjacent plaque had necrotic core with a thin overlying fibrous cap. The remaining tissue next to the dissection plane was fibrotic. This case illustrates that neointimal hyperplasia may organize into an unstable plaque, with a thin fibrous cap overlying a lipid-rich necrotic core-a so-called virtual histology thin-capped fibroatheroma. As defined in the PROSPECT trial, the in-stent stenotic lesion in our case conformed to the definition of a high-risk plaque-it had an MLA <4 mm(2) , plaque burden was ≥70%, and there was >10% necrotic core. It became unstable and ruptured. The demonstrated findings of this case may sway physicians against sealing hemodynamically nonsignificant unstable plaques. © 2010 Wiley-Liss, Inc. |
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Authors:
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Stephen P Hoole; Andrew Starovoytov; Jaap N Hamburger |
Publication Detail:
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Type: Journal Article Date: 2010-12-03 |
Journal Detail:
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Title: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions Volume: 77 ISSN: 1522-726X ISO Abbreviation: Catheter Cardiovasc Interv Publication Date: 2011 May |
Date Detail:
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Created Date: 2011-04-26 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100884139 Medline TA: Catheter Cardiovasc Interv Country: United States |
Other Details:
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Languages: eng Pagination: 841-2 Citation Subset: IM |
Copyright Information:
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Copyright © 2010 Wiley-Liss, Inc. |
Affiliation:
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Vancouver General Hospital, Vancouver, British Columbia, Canada. |
Export Citation:
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Descriptor/Qualifier:
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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