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Percutaneous Left Atrial Appendage Occlusion for Patients in Atrial Fibrillation Suboptimal for Warfarin Therapy: 5-year Results of the PLAATO (Percutaneous Left Atrial Appendage Transcatheter Occlusion) Study Impact of Transcatheter Mitral Valve Repair on Preprocedural and Postprocedural Hospitalization Rates Rivaroxaban for Thromboprophylaxis in High-Risk Ambulatory Patients With Cancer Prospective Evaluation of Transseptal TMVR for Failed Surgical Bioprostheses: MITRAL Trial Valve-in-Valve Arm 1-Year Outcomes Implications of the local hemodynamic forces on the formation and destabilization of neoatherosclerotic lesions Risk of Cardiovascular Diseases Among Older Breast Cancer Survivors in the United States: A Matched Cohort Study Strain-Guided Management of Potentially Cardiotoxic Cancer Therapy Evolving insights into the role of local shear stress in late stent failure from neoatherosclerosis formation and plaque destabilization Long-Term Outcomes of Patients With Mediastinal Radiation–Associated Coronary Artery Disease Undergoing Coronary Revascularization With Percutaneous Coronary Intervention and Coronary Artery Bypass Grafting Ablation Versus Drug Therapy for Atrial Fibrillation in Heart Failure Results From the CABANA Trial

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...