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Clinical impact of PCSK9 inhibitor on stabilization and regression of lipid-rich coronary plaques: a near-infrared spectroscopy study Considerations for Optimal Device Selection in Transcatheter Aortic Valve Replacement: A Review Primary Prevention Trial Designs Using Coronary Imaging: A National Heart, Lung, and Blood Institute Workshop Impact of post-intervention minimal stent area on 9-month follow-up patency of paclitaxel-eluting stents: an integrated intravascular ultrasound analysis from the TAXUS IV, V, and VI and TAXUS ATLAS Workhorse, Long Lesion, and Direct Stent Trials Clinical impact of conduction disturbances in transcatheter aortic valve replacement recipients: a systematic review and meta-analysis Association of Reduced Apical Untwisting With Incident HF in Asymptomatic Patients With HF Risk Factors Percutaneous Coronary Intervention for Vulnerable Coronary Atherosclerotic Plaque Why and How to Measure Aortic Valve Calcification in Patients With Aortic Stenosis Intracoronary stenting without anticoagulation accomplished with intravascular ultrasound guidance Contribution of stent underexpansion to recurrence after sirolimus-eluting stent implantation for in-stent restenosis

Clinical Case Study2019 Jul 13.[Epub ahead of print]

JOURNAL:Eur Heart J Cardiovasc Imaging. Article Link

Healed coronary plaque rupture as a cause of rapid lesion progression: a case demonstrated with in vivo histopathology by directional coronary atherectomy

Tsuchiya H, Nakano A, Nakamura N et al. Keywords: healed coronary plaque rupture; lesion progression; directional coronary atherectomy

ABSTRACT

Coronary plaque rupture is a culprit lesion morphology of thrombotic events leading to acute coronary syndrome (ACS). Meanwhile, coronary plaque rupture often occurs silently and heals spontaneously. This phenomenon is recognized as healed plaque rupture (HPR) in pathological studies. HPR is considered to be a cause of lesion progression, although most reports have been based on ex vivo autopsy specimens, therefore HPR remains underappreciated.


A 75-year-old man with a history of previous percutaneous coronary intervention to the left circumflex artery was admitted with recurrent ACS. Coronary angiography revealed rapid progressive lesion in the right coronary artery, where only mild stenosis existed 4 months prior (Panels A and...