Atherosclerotic Plaque Component as a Risk Factor for Distal Embolization During Percutaneous Coronary Intervention - Pathology of Tissue Obtained by Distal Protection Device
| Autor: | Yoshio Yasumura, Masahiko Tsujimoto, Hiroyuki Hao, Rika Kawakami, Yoshiharu Higuchi, Akiko Fujino, Seiichi Hirota, Sayaka Shimodai, Yasunori Ueda, Koshi Matsuo |
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| Rok vydání: | 2018 |
| Předmět: |
Male
Pathology medicine.medical_specialty Acute coronary syndrome medicine.medical_treatment Embolism 030204 cardiovascular system & hematology Coronary Angiography Embolic Protection Devices Microcirculation Coronary artery disease 03 medical and health sciences 0302 clinical medicine Percutaneous Coronary Intervention Risk Factors Medicine Humans 030212 general & internal medicine Risk factor Acute Coronary Syndrome Pathological Aged Retrospective Studies business.industry Percutaneous coronary intervention Thrombosis General Medicine Middle Aged medicine.disease Platelet Activation Plaque Atherosclerotic Conventional PCI Multivariate Analysis Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | Circulation journal : official journal of the Japanese Circulation Society. 82(9) |
| ISSN: | 1347-4820 |
| Popis: | Background Embolism during percutaneous coronary intervention (PCI) causes microcirculation impairment. The aim of this study was to clarify the relationship between the pathological characteristics of tissue captured by distal protection device (DPD) and amount of tissue accumulated in DPD. Methods and Results: A total of 671 consecutive lesions in PCI using DPD were examined. The amount of necrotic debris, fibrous tissue, calcified particle, platelet thrombus and organized thrombus in the DPD baskets was histologically evaluated. The DPD tissue amount was assessed semi-quantitatively, and the relationship between the captured DPD tissue characteristics and tissue amount was investigated. On pathology, 40.7% of the lesions had necrotic debris, 41.4% had fibrous tissue, and 18.0% had calcified particle. The prevalence of lesions in patients with acute coronary syndrome (ACS) was 62.1%. Tissue amount score distribution was as follows: score 1 (tissue invisible), 3.9%; score 2 (tissue clinging to the basket), 52.0%; score 3 (tissue accumulated at the bottom of the basket), 38.5%; and score 4 (tissue accumulated in more than half of the basket), 5.7%. On multivariate analysis, necrotic debris and fibrous tissue were associated with greater tissue amount as well as clinical presentation of ACS. Conclusions The presence of atherosclerotic plaque component, such as necrotic debris and fibrous tissue, might be a risk for distal embolism during PCI. |
| Databáze: | OpenAIRE |
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