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J Am Coll Cardiol, 2006; 47:1754-1768, doi:10.1016/j.jacc.2005.12.051 (Published online 17 April 2006).
© 2006 by the American College of Cardiology Foundation
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Fourth Annual American College of Cardiology International Lecture

A Journey in the Interventional Field

Patrick W. Serruys, MD, PhD, FESC, FACC*

Thoraxcenter, Erasmus Medical Center, Rotterdam, the Netherlands.


Figure 1
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Figure 1 The rosy prophecy. ARTS = Arterial Revascularization Therapies Study; CABG = coronary artery bypass graft; CABRI = Coronary Angioplasty versus Bypass Revascularization Investigation; MI = myocardial infarction; PTCA = percutaneous transluminal coronary angioplasty.

 

Figure 2
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Figure 2 Endothelial progenitor cell capture stent. (A) Bare stent; (B) coated stent.

 

Figure 3
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Figure 3 (A) Normal mechanism of vessel stress; (B) effect of a device eluting nitric oxide. SMC = smooth muscle cell.

 

Figure 4
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Figure 4 Where we have come from and where we are going: the next innovative steps in vascular intervention.

 

Figure 5
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Figure 5 The "new diagnostic world" of the vulnerable plaque.

 

Figure 6
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Figure 6 (A) Angiographic image of an intermediate lesion in the proximal right coronary artery; (B) corresponding multislice computed tomographic image of the lesion (vertical view); (C) corresponding multislice computed tomographic image of the lesion (horizontal view); (D) enlarged view of the clacified plaque in panel C; and (E) corresponding intravascular ultrasonic image of the calcified plaque. AV = atrioventricular.

 

Figure 7
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Figure 7 Multislice computed tomography (MSCT) plaque burden: an ubiquitous phenomenon. Results: distribution of any plaque-% (large plaque-%). LCA = left coronary artery; RCA = right coronary artery.

 

Figure 8
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Figure 8 Diagnostic value of palpography. CRP = C-reactive protein; ROC = receiver-operating characteristic.

 

Figure 9
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Figure 9 Virtual histology or ... how to convert an ex vivo (pressurized) intravascular ultrasound image into a color-coded histological cross section. (A) Intravascular ultrasound cross section; (B) in vivo virtual histology color-coded of same cross section; (C) ex vivo histology of same cross section; (D) color pencil sketch of ex vivo histology cross section.

 

Figure 10
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Figure 10 Optical coherence tomography showing detailed three layer resolution of a coronary vessel.

 

Figure 11
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Figure 11 (A) Optical coherence tomography showing thin cap fibrous atheroma and (B and C) intramuscular capillary.

 

Figure 12
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Figure 12 Vulnerable plaque triage. CRP = C-reactive protein; DES = drug-eluting stents; EEM = external elastic membrane.

 

Figure 13
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Figure 13 Phantom made of cryogel mimicking a total occlusion of which the cross section is seen by a forward-looking (60°) optical coherence imaging wire (0.014 inch). OCT = optical coherence tomography.

 

Figure 14
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Figure 14 Has the myocardium its own stem cells? Arrows = C-Kit+ cells. C-Kit is an antigen of staminality. Its expression is a proof of staminal potential of these cells. These cells are still uncommitted. Arrowheads = cells expressing MEF2C. MEF2C is a transcription factor expressed early in the myocyte lineage. These cells are committed early to myocyte lineage. *Alpha-sarcomeric actin. This cell is engaged in a more advanced stage of myocyte lineage. Reprinted, with permission, from Beltrami et al. (66).

 





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