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Morphologic changes in infarct-related plaque after coronary stent placement

A serial angioscopy study

^* Department of Cardiovascular Center, Chiba-Hokusoh Hospital, Nippon Medical School, Chiba, Japan

View larger version (13K): [in a new window]   figure 1 Coronary angioscopy procedures. *failure of the angioscopy procedure was defined as when the angioscope could not visualize the entire circumference of the target lesion in order for it to be adequately evaluated or if it could not reach to the target lesion because of a tortuous proximal vessel.

View larger version (32K): [in a new window]   figure 2 Changes in the incidence of thrombus and intimal flap. the intimal flap was assessable in 28 of 39 lesions at baseline. in the 11 remaining lesions, the intimal flap could not be seen because it occupied the lumen due to occlusive thrombus. *p < 0.01 vs. protruding thrombus at baseline. p < 0.01 vs. protruding thrombus immediately after balloon angioplasty. #p < 0.01 vs. lining thrombus immediately after stenting. p < 0.01 vs. intimal flap immediately after balloon angioplasty. solid bars = protruding thrombus; hatched bars = lining thrombus; open bars = intimal flap.

View larger version (26K): [in a new window]   figure 3 Changes in the plaque surface (a) and color (b) after stenting. *p < 0.01 vs. immediately after stenting and one-month follow-up.

View larger version (18K): [in a new window]   figure 4 Changes in the stent coverage score after stenting. data are presented as the mean value ± sd.

View larger version (66K): [in a new window]   Figure 5 Serial angioscopic images. (A) At baseline, a protruding mixed thrombus was seen. (B) Immediately after balloon angioplasty, a protruding thrombus and intimal flap were seen. (C) Immediately after stenting, a wide vessel lumen was obtained by the stent. (D) At one-month follow-up, a lining thrombus was seen. (E) At one-month follow-up, there was partial neointimal coverage (coverage score = 1). (F) At six-month follow-up, there was smooth and white plaque (coverage score = 4) without thrombus. F = intimal flap; GW = guide wire; L = lumen; YP = yellow plaque; T = thrombus.