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FFR-guided multivessel stenting reduces urgent revascularization compared with infarct-related artery only stenting in ST-elevation myocardial infarction: A meta-analysis of randomized controlled trials The prognostic role of mid-range ejection fraction in ST-segment elevation myocardial infarction Surgical or Transcatheter Aortic-Valve Replacement in Intermediate-Risk Patients Classic crush and DK crush stenting techniques The HACD4 haplotype as a risk factor for atherosclerosis in males Coronary Artery Plaque Characteristics Associated With Adverse Outcomes in the SCOT-HEART Study Changes in One-Year Mortality in Elderly Patients Admitted with Acute Myocardial Infarction in Relation with Early Management LOX-1 in Atherosclerosis and Myocardial Ischemia: Biology, Genetics, and Modulation The association between body mass index and obesity with survival in pulmonary arterial hypertension A sirolimus-eluting bioabsorbable polymer-coated stent (MiStent) versus an everolimus-eluting durable polymer stent (Xience) after percutaneous coronary intervention (DESSOLVE III): a randomised, single-blind, multicentre, non-inferiority, phase 3 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...