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Heart Disease and Stroke Statistics-2019 Update: A Report From the American Heart Association Thin Composite-Wire-Strut Zotarolimus-Eluting Stents Versus Ultrathin-Strut Sirolimus-Eluting Stents in BIONYX at 2 Years Randomized Comparison Between Radial and Femoral Large-Bore Access for Complex Percutaneous Coronary Intervention Long-Term Prognostic Implications of Previous Silent Myocardial Infarction in Patients Presenting With Acute Myocardial Infarction 2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society Early Diagnosis of Myocardial Infarction With Point-of-Care High-Sensitivity Cardiac Troponin I A Randomized Trial Comparing the NeoVas Sirolimus-Eluting Bioresorbable Scaffold and Metallic Everolimus-Eluting Stents Efficacy and Safety of Stents in ST-Segment Elevation Myocardial Infarction Guiding Principles for Chronic Total Occlusion Percutaneous Coronary Intervention Treatment of higher-risk patients with an indication for revascularization: evolution within the field of contemporary percutaneous coronary intervention

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...