Author + information
- Victor Demin,
- Alexander Tchevytchalov,
- Stanislav Dolgov,
- Alexey Demin,
- Marina Murzaykina,
- Denis Demin and
- Andrey Zherdev
Intravascular ultrasound (IVUS) with radio-frequency analysis of the reflected signal extends greyscale IVUS, makes it possible to differentiate the histological structure of atheroma, with the designation of necrotic core, dense calcium, fibrous, fibro-fatty tissue. The aim of the study was to assess the qualitative and quantitative atheromatous substrate changes by coronary arteries stenting of hemodynamically significant stenoses.
The study of the volume and morphology of the plaque was performed in 102 patients with stable angina by intravascular ultrasound radio-frequency spectral analysis: “virtual histology” or i-Map. Evaluation of the affected segment was performed before, during and after stenting.
The plaques at the site of maximum stenosis were homogeneous in 9 patients of 102; heterogeneous - in 30, in 59 patients - plaques were of the mixed character. The patients were implanted 143 drug-eluting stents, an average of 1.4 stents on the affected segment. Stent length ranged from 12 to 38 mm, the total length of stented segment up to 60 mm. After stenting according to the IVUS data stenosis of the target segment has decreased from 74.1 ± 7.7 % to 45.6 ± 8.3 %; p <0.001. In the area of maximum stenosis after stenting the plaque area has decreased from 9.1 ± 4.5 mm2 to 3.8 ± 2.6 mm2 (58.3 %, p <0.001). Moreover, fibrous and fibro-fatty tissue has been much more reduced (67.6 % and 62.2 %, respectively), to a lesser extent - necrotic core (48 %) and dense calcium has remained practically unchanged (5 %). The reduction in plaque volume throughout the segment impact has been marked, but it was minimal - an average of 3.3 % (7,89 ± 54,07 mm3). Fibrous and fibro-fatty tissues are been reduced throughout the target segment. By the depiction of the stented area the complete isolation of the stent is currently not technically feasible, that will increase the image of dense calcium and to a lesser extent necrotic core.
The lumen increase after coronary arteries stenting according to IVUS data with radiofrequency analysis is the result of reducing volume of atheromatous plaque, primarily due to the fibrous and fibro-fatty tissue as well as through the redistribution of plaque along the affected segment.
- 2013 American College of Cardiology Foundation