Association between plaque characteristics and the amount of debris captured by a filter-type distal protection device in patients with acute coronary syndrome. (March 2017)

• Record Type: Journal Article
• Authors: Kitagawa, Katsuhide; Amano, Tetsuya; Uetani, Tadayuki; Ishii, Hideki; Okumura, Takahiro; Suzuki, Susumu; Takashima, Hiroaki; Kurita, Akiyoshi; Ando, Hirohiko; Matsubara, Tatsuaki; Murohara, Toyoaki
• Is Part Of: Atherosclerosis. Volume 258(2017)
• Page Start: 72
• Page End: 78
• Publication Date: 2017-03
• Subjects: Distal protection device -- Post procedural myocardial infarction integrated backscatter intravascular ultrasound -- Acute coronary syndrome; Arteriosclerosis -- Periodicals; Electronic journals; 616.136
• DOI: 10.1016/j.atherosclerosis.2017.02.001
• Languages: English
• ISSNs: 0021-9150

Abstract

Abstract: Background and aims: Disruption of atherosclerotic plaque and distal embolism often cause peri-procedural myocardial injury during percutaneous coronary intervention (PCI). In the present study, we evaluate the association between the characteristics of the target lesion and the amount of debris captured by the filter-type distal protection device. Methods: We enrolled 120 consecutive patients with acute coronary syndrome, who underwent coronary stent implantation with a filter-type distal protection device after integrated backscatter intravascular ultrasound (IB-IVUS) analysis. The amount of debris captured by the protection filter was measured through microscopic evaluation. Results: The lipid and fibrous volume evaluated with IB-IVUS was significantly correlated with the amount of the captured debris (r = 0.657, p < 0.01), (r = 0.322, p < 0.01). The lipid plaque fraction showed a positive correlation (r = 0.335, p < 0.01), while the fibrous plaque fraction was found to be inversely correlated (r = −0.375, p < 0.01) with the amount of captured debris. Multivariate regression analysis showed that lipid volume correlated independently with the amount of captured debris. Conclusion: The volume of the lipid-rich plaque was associated with the amount of procedure-related debris released and captured by the filter-type distal protection device. Highlights: PMI in percutaneous coronary intervention (PCI) is a predictor of subsequent mortality and poor clinical outcomes. We used both of IVUS and filter-type distal protection device in PCI procedures. Coronary plaque characteristics and the amount of debris were evaluated. The volume of lipid-rich plaque predicted the amount of procedure-related debris.