Intravascular ultrasound appearance of scattered necrotic core as an index for deterioration of coronary flow during intervention in acute coronary syndrome
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Kenji Sakata Masa-aki Kawashiri Hidekazu Ino Takao Matsubara Yoshihide Uno Toshihiko Yasuda Kenji Miwa Honin Kanaya Masakazu Yamagis
- چاپ و سال / کشور: 2011
Description
In acute coronary syndrome (ACS) patients with deterioration of coronary flow during percutaneous coronary intervention (PCI), a scattered necrotic core pattern (SNC) is observed by intravascular ultrasound virtual histology (VH-IVUS). The purpose of this study was to evaluate the impact of SNC on deterioration of coronary flow during PCI in ACS. A total of 38 ACS patients were imaged using VH-IVUS before PCI. In addition to conventional definitions of thin-cap fibroatheroma by VHIVUS (ID-TCFA), the SNC was defined as necrotic core foci with a maximum diameter of\14 pixels on a 400 9 400 VH-IVUS image in the presence of [50% plaque burden except in the ID-TCFA frame. Patients were divided into deterioration of coronary flow group (n = 15) and normal-reflow group (n = 23). The incidence of residual thrombus and plaque rupture, the external elastic membrane, plaque and fibrous volumes, the incidence of IDTCFA and the average number of SNC per frame was significantly greater in deterioration of coronary flow group than in normal-reflow group (all parameters P \ 0.05). Multivariate analysis revealed that the average number of SNC per frame was independently associated with deterioration of coronary flow in ACS patients (odds ratio 1.18, P\0.05). In conclusion, an increased number of SNC is associated with deterioration of coronary flow during PCI in ACS patients.
Heart Vessels DOI 10.1007/s00380-011-0175-8 Received: 11 August 2010 / Accepted: 8 July 2011
