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Characterization of lesions undergoing ischemia-driven revascularization after complete revascularization versus culprit lesion only in patients with STEMI and multivessel disease - A DANAMI-3-PRIMULTI substudy Association of Silent Myocardial Infarction and Sudden Cardiac Death A Test in Context: E/A and E/e' to Assess Diastolic Dysfunction and LV Filling Pressure An EAPCI Expert Consensus Document on Ischaemia with Non-Obstructive Coronary Arteries in Collaboration with European Society of Cardiology Working Group on Coronary Pathophysiology & Microcirculation Endorsed by Coronary Vasomotor Disorders International Study Group Heart Regeneration by Endogenous Stem Cells and Cardiomyocyte Proliferation: Controversy, Fallacy, and Progress Diagnosis and Prognosis of Coronary Artery Disease with SPECT and PET Chronic Total Occlusion Percutaneous Coronary Intervention: Evidence and Controversies Subcutaneous Selatogrel Inhibits Platelet Aggregation in Patients With Acute Myocardial Infarction Prognostic Value of SYNTAX Score in Patients With Infarct-Related Cardiogenic Shock: Insights From the CULPRIT-SHOCK Trial Association of Plaque Location and Vessel Geometry Determined by Coronary Computed Tomographic Angiography With Future Acute Coronary Syndrome–Causing Culprit Lesions

Clinical Case Study2018 Jan 1;19(1):116.

JOURNAL:Eur Heart J Cardiovasc Imaging. Article Link

In vivo comparison of lipid-rich plaque on near-infrared spectroscopy with histopathological analysis of coronary atherectomy specimens

Nishihira K, Asaumi Y, Kataoka Y et al. Keywords: atherectomy, coronary spectroscopy, near-infrared lipids

ABSTRACT


A 42-year-old man with angina pectoris was hospitalized to undergo percutaneous coronary intervention (PCI) for a significant stenosis in the mid-left anterior descending (LAD) coronary artery (Panel A). Optical coherence tomography (OCT) and near-infrared spectroscopy (NIRS) imaging at the arrowhead site identified the presence of lipid-rich plaque, exhibiting a high maximum 4-mm lipid core burden index (max-LCBI) with the value of 925 (Panels B and C; Supplementary data online, Video S1). Following PCI with directional coronary atherectomy (DCA), resection of the lipid-rich plaque was observed on OCT imaging (Panels D and D’; Supplementary data online, Video S2). Corresponding NIRS imaging demonstrated a marked reduction of yellow signals on chemogram accompanied by decrease in max-LCBI to 248 (Panel E,asterisk).