Laser Vaporization of Intracoronary Thrombus and Identifying Plaque Morphology in ST-Segment Elevation Myocardial Infarction as Assessed by Optical Coherence Tomography
Objectives. We evaluated the thrombus-vaporizing effect of excimer laser coronary angioplasty (ELCA) in patients with ST-segment elevation myocardial infarction (STEMI) by optical coherence tomography (OCT). Background. Larger intracoronary thrombus elevates the risk of interventional treatment and...
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| Format: | Article |
| Language: | English |
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Wiley
2021-01-01
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| Series: | Journal of Interventional Cardiology |
| Online Access: | http://dx.doi.org/10.1155/2021/5590109 |
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| author | Yuki Yamanaka Yoshihisa Shimada Daisuke Tonomura Kazunori Terashita Tatsuya Suzuki Kentaro Yano Satoshi Nishiura Masataka Yoshida Takao Tsuchida Hitoshi Fukumoto |
| author_facet | Yuki Yamanaka Yoshihisa Shimada Daisuke Tonomura Kazunori Terashita Tatsuya Suzuki Kentaro Yano Satoshi Nishiura Masataka Yoshida Takao Tsuchida Hitoshi Fukumoto |
| author_sort | Yuki Yamanaka |
| collection | DOAJ |
| description | Objectives. We evaluated the thrombus-vaporizing effect of excimer laser coronary angioplasty (ELCA) in patients with ST-segment elevation myocardial infarction (STEMI) by optical coherence tomography (OCT). Background. Larger intracoronary thrombus elevates the risk of interventional treatment and mortality in patients with STEMI. Methods. A total of 92 patients with STEMI who presented within 24 hours from the onset and underwent ELCA following manual aspiration thrombectomy (MT) were analyzed. Results. The mean baseline thrombolysis in myocardial infarction flow grade was 0.4 ± 0.6, which subsequently improved to 2.3 ± 0.7 after MT (p<0.0001) and 2.7 ± 0.5 after ELCA (p=0.0001). The median residual thrombus volume after MT was 65.7 mm3, which significantly reduced to 47.5 mm3 after ELCA (p<0.0001). Plaque rupture was identified by OCT in only 22 cases (23.9%) after MT, but was distinguishable in 36 additional cases after ELCA (total: 58 cases; 63.0%). Ruptured lesions contained a higher proportion of red thrombus than nonruptured lesions (75.9% vs. 43.3%, p=0.001). Significantly larger thrombus burden after MT (69.6 mm3 vs. 56.3 mm3, p<0.05) and greater thrombus reduction by ELCA (21.2 mm3 vs. 11.8 mm3, p<0.01) were observed in ruptured lesions than nonruptured lesions. Conclusions. ELCA effectively vaporized intracoronary thrombus in patients with STEMI even after MT. Lesions with plaque rupture contained larger thrombus burden that was frequently characterized by red thrombus and more effectively reduced by ELCA. |
| format | Article |
| id | doaj-art-f3002fbb55d54958ad2da629fb744f33 |
| institution | Kabale University |
| issn | 0896-4327 1540-8183 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Interventional Cardiology |
| spelling | doaj-art-f3002fbb55d54958ad2da629fb744f332025-02-03T01:04:33ZengWileyJournal of Interventional Cardiology0896-43271540-81832021-01-01202110.1155/2021/55901095590109Laser Vaporization of Intracoronary Thrombus and Identifying Plaque Morphology in ST-Segment Elevation Myocardial Infarction as Assessed by Optical Coherence TomographyYuki Yamanaka0Yoshihisa Shimada1Daisuke Tonomura2Kazunori Terashita3Tatsuya Suzuki4Kentaro Yano5Satoshi Nishiura6Masataka Yoshida7Takao Tsuchida8Hitoshi Fukumoto9Cardiovascular Center, Shiroyama Hospital, 2-8-1 Habikino, Habikino 583-0872, JapanCardiovascular Center, Shiroyama Hospital, 2-8-1 Habikino, Habikino 583-0872, JapanCardiovascular Center, Shiroyama Hospital, 2-8-1 Habikino, Habikino 583-0872, JapanCardiovascular Center, Shiroyama Hospital, 2-8-1 Habikino, Habikino 583-0872, JapanCardiovascular Center, Shiroyama Hospital, 2-8-1 Habikino, Habikino 583-0872, JapanCardiovascular Center, Shiroyama Hospital, 2-8-1 Habikino, Habikino 583-0872, JapanCardiovascular Center, Shiroyama Hospital, 2-8-1 Habikino, Habikino 583-0872, JapanCardiovascular Center, Shiroyama Hospital, 2-8-1 Habikino, Habikino 583-0872, JapanCardiovascular Center, Shiroyama Hospital, 2-8-1 Habikino, Habikino 583-0872, JapanCardiovascular Center, Shiroyama Hospital, 2-8-1 Habikino, Habikino 583-0872, JapanObjectives. We evaluated the thrombus-vaporizing effect of excimer laser coronary angioplasty (ELCA) in patients with ST-segment elevation myocardial infarction (STEMI) by optical coherence tomography (OCT). Background. Larger intracoronary thrombus elevates the risk of interventional treatment and mortality in patients with STEMI. Methods. A total of 92 patients with STEMI who presented within 24 hours from the onset and underwent ELCA following manual aspiration thrombectomy (MT) were analyzed. Results. The mean baseline thrombolysis in myocardial infarction flow grade was 0.4 ± 0.6, which subsequently improved to 2.3 ± 0.7 after MT (p<0.0001) and 2.7 ± 0.5 after ELCA (p=0.0001). The median residual thrombus volume after MT was 65.7 mm3, which significantly reduced to 47.5 mm3 after ELCA (p<0.0001). Plaque rupture was identified by OCT in only 22 cases (23.9%) after MT, but was distinguishable in 36 additional cases after ELCA (total: 58 cases; 63.0%). Ruptured lesions contained a higher proportion of red thrombus than nonruptured lesions (75.9% vs. 43.3%, p=0.001). Significantly larger thrombus burden after MT (69.6 mm3 vs. 56.3 mm3, p<0.05) and greater thrombus reduction by ELCA (21.2 mm3 vs. 11.8 mm3, p<0.01) were observed in ruptured lesions than nonruptured lesions. Conclusions. ELCA effectively vaporized intracoronary thrombus in patients with STEMI even after MT. Lesions with plaque rupture contained larger thrombus burden that was frequently characterized by red thrombus and more effectively reduced by ELCA.http://dx.doi.org/10.1155/2021/5590109 |
| spellingShingle | Yuki Yamanaka Yoshihisa Shimada Daisuke Tonomura Kazunori Terashita Tatsuya Suzuki Kentaro Yano Satoshi Nishiura Masataka Yoshida Takao Tsuchida Hitoshi Fukumoto Laser Vaporization of Intracoronary Thrombus and Identifying Plaque Morphology in ST-Segment Elevation Myocardial Infarction as Assessed by Optical Coherence Tomography Journal of Interventional Cardiology |
| title | Laser Vaporization of Intracoronary Thrombus and Identifying Plaque Morphology in ST-Segment Elevation Myocardial Infarction as Assessed by Optical Coherence Tomography |
| title_full | Laser Vaporization of Intracoronary Thrombus and Identifying Plaque Morphology in ST-Segment Elevation Myocardial Infarction as Assessed by Optical Coherence Tomography |
| title_fullStr | Laser Vaporization of Intracoronary Thrombus and Identifying Plaque Morphology in ST-Segment Elevation Myocardial Infarction as Assessed by Optical Coherence Tomography |
| title_full_unstemmed | Laser Vaporization of Intracoronary Thrombus and Identifying Plaque Morphology in ST-Segment Elevation Myocardial Infarction as Assessed by Optical Coherence Tomography |
| title_short | Laser Vaporization of Intracoronary Thrombus and Identifying Plaque Morphology in ST-Segment Elevation Myocardial Infarction as Assessed by Optical Coherence Tomography |
| title_sort | laser vaporization of intracoronary thrombus and identifying plaque morphology in st segment elevation myocardial infarction as assessed by optical coherence tomography |
| url | http://dx.doi.org/10.1155/2021/5590109 |
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